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Biomedical subjects

H W Wahl

Publications and source records attributed to H W Wahl.

At least 19 recordsLinked to original sources
PubMed2000

[Success and variability of success of inpatient rehabilitation of the elderly: an empirical study based on medical-psychiatric and psychosocial indicators].

This study considers findings of psychological gerontology as particularly important for geriatric rehabilitation research. Its concrete aim was to describe the course and outcome of geriatric rehabilitation based on a wide range of success criteria, to explore the influencing role of age, sex, and diagnosis as well as to describe the variability pattern of success. The data were gathered from a sample of 100 older adults who underwent treatment in a German inpatient rehabilitation unit. Participants were assessed across five measurement occasions by use of a state-of-the-art geriatric assessment and a psychological data collection part. The results underline, for one, that significant improvements of functional as well as psychological capacity were obtained. Second, age and sex played practically no role concerning the course of the success criteria, whereas diagnosis revealed some statistically meaningful effects. Third, it was found that the variability of success was characterized by a relatively homogeneous pattern of gain with regard to functional criteria; with respect to psychological variables, heterogeneity was more pronounced and some participants show loss as well, a chance for further improvement of the geriatric rehabilitation.

Adult↗
PubMed2000

[Changes in aging today and tomorrow--contributions of interventional gerontology].

This paper starts with the insight that today's intervention gerontology provides a very broad scope of strategies with impact on the course of normal aging as well as aging with competence losses. Also, it is assumed that this impact of intervention gerontology will grow even further in the future. In the following, current intervention gerontology research is discussed by particularly highlighting its connection with basic gerontology findings, the contextual view of aging, the interdisciplinary orientation, and the methodological standard. With respect to the potential of gero-intervention in the future, three prototypical domains are considered: (1) health and everyday competence, (2) living environments, and (3) communication.

Aged↗
PubMed1999

[Psychological gerontology in German-speaking countries 1988-1998: introduction, cognitive development in aging (I)].

In this four-part review article, an update of psychological gerontology since 1988 in German speaking countries is given as follows: Cognitive development in old age (part I), personality development in old age (part II), social relations in old age (part III), tasks, burdens, and border situations in old age (part IV). In part I of the update which is presented in this issue, the description of recent trends in cognitive research serves as a background to highlight, in a first step, the basic research in the field concerned with the mechanics as well as the pragmatics of intelligence in the later years. In a further step, research on memory processes including psychological work with relevance for the investigation of dementia is reviewed. Finally, cognitive intervention studies reflecting the impact of an applied cognitive gero-psychology and aimed to support the potential and limits of the plasticity of the intelligence and memory development in old age find consideration.

Aged↗
PubMed1999

[Personality development in old age].

In this four-part review article, an update of Psychological Gerontology since 1988 in German speaking countries is given. Part II of this review focuses an personality development in old age. In accordance with their current relevance within research on personality development, concepts and empirical studies concerned with coping, psychological resilience and development regulation in old age are addressed in the first part of this review (contributions to basic research). First, research based on the two-process-model of coping, the personality theory of Thomae and the life-span theory of control is summarized. Next, work on subjective well-being, self and self-regulation are highlighted. In the second part of the review (contribution to applied research), an overview of the scope of potential of psychotherapeutic intervention in old age is given.

Adaptation, Psychological↗
PubMed1999

[III. Social relationships].

In this four-part review article, an update of psychological gerontology from 1988 to 1997/1998 in German speaking countries is given. Part III of this review focuses on social relationships in old age. Two perspectives are chosen for this analysis. The first perspective describes the process of actively coping with developmental tasks in social relationship - the elderly are not seen as a "passive" but as an "active" part in social relationships. Moreover, this perspective focuses on empirical relations between different patterns of social integration and the psychological situation in old age. The second perspective stresses on a special aspect of social engagement: the engagement and productivity in intergenerational relationships. Empirical data make clear that the elderly not only receive (emotional and instrumental) support, but also give a lot of support in these relationships.

Aged↗
PubMed1999

[Tasks, burdens and borderline situations in old age. General discussion].

In this four-part review article, an update covering the geropsychological research since 1988 in German speaking countries is given as follows: Cognitive development in old age (part I), personality development in old age (part II), social relations in old age (part III), age-related tasks, burdens, and border situations (part IV). In part IV of the update presented in this issue, research contributing to a competence perspective of old age and aging is summarized under four main headings: (1) Independence, everyday life, and everyday competence; (2) aging in spatial, physical, and technical environments; (3) health and coping with illness; (4) coping with death and dying. The article ends with a general discussion considering as well the findings of our survey addressing gerontologists from German speaking countries.

Aged↗
PubMed1999

Psychosocial consequences of age-related visual impairment: comparison with mobility-impaired older adults and long-term outcome.

Indices of behavioral competence (activities of daily living [ADLs], instrumental activities of daily living [IADLs], use of outdoor resources, leisure activity level) as well as emotional adaptation (subjective well-being, future orientation) were used to investigate the psychosocial consequences of age-related vision impairment in a threefold manner: (a) comparison of visually impaired and unimpaired elders, (b) comparison of visually impaired and mobility-impaired elders, and (c) long-term adaptation across 5 years. The research design used (a) 42 severely visually impaired elders, (b) 42 blind elders, (c) 42 mobility-impaired elders, and (d) 42 unimpaired elders. Compared with the mobility impaired, the visually impaired demonstrated lower IADL competence but no difference in emotional adaptation. The long-term adjustment of the visually impaired remained relatively stable in the behavioral domain, although lower compared with the unimpaired elders. Emotional adaptation decreased over the 5-year longitudinal interval in the visually impaired and the unimpaired group, but the decrease was generally higher in the visually impaired group. Conceptual ideas from environmental gerontology as well as psychological resilience are used to interpret these results.

Activities of Daily Living↗
PubMed1999

Everyday competence in visually impaired older adults: a case for person-environment perspectives.

In this article, the need for an explicit consideration of the environment in order to address everyday competence (EC) in old age is illustrated based on an analysis of the day-to-day challenges of visually impaired older adults. Data are based on a sample of elderly adults suffering from different degrees of visual impairment (visually severely impaired vs blind, each N = 42) and a control group of visually unimpaired elderly persons (N = 42) with age means between 74.9 and 76.8 years. Findings underscore that: (a) EC, regarded as an outcome, is negatively affected by low person-environment fit in the home environment in visually impaired older adults but not in the visually unimpaired elderly population; (b) EC, understood as daily compensatory processes, is more pronounced in the visually impaired with respect to some compensation modes (e.g., use of latent skills), but not all; and (c) EC, as a predictor variable for outdoor behavior, assumes a particularly critical role when outside environmental press is high.

Activities of Daily Living↗
PubMed1998

[Deteriorating vision in the elderly: double stress?].

BACKGROUND: Epidemiologic studies have provided clear evidence that the majority of people affected by severe visual impairment are adults above the age of 60 years. The goal of this psychological research was to analyze the emotional and behavioral consequences of age-related visual impairment in three steps: descriptive data concerned with subjective well-being, depression, everyday competence, and leisure as well as explanations of interindividual variability based on individual and environmental variables are presented (study I). Also, the impact of the time of onset (early versus late in life) is addressed (study II). Finally, the role of the living accomodation (institutional versus private household) was the main target of another study (study III). MATERIALS AND METHODS: Study I was based on 84 elderly adults who experienced an irreversible visual loss after age 55 years; a control group of unimpaired elderly adults is also included (mean age 75.8, range 59 to 92). In study II, 18 elderly adults who had been blind since their early childhood were compared to nine matched elderly adults who experienced blindness in their later life as well as nine matched unimpaired elderly adults (mean age 71.7, range 63 to 83). The data for study III came from 15 visually impaired institutional residents who were compared to 15 matched unimpaired residents and 15 matched visually impaired and 15 unimpaired older adults living in private households (mean age 87.0, range 78 to 93). All subjects underwent an intensive psychological measurement program. RESULTS: The findings of study I emphasize that age-related visual impairment is associated with lower subjective well-being, greater depression, reduced everyday competence, and lowered leisure activity level. A significant portion of interindividual variability in these outcomes can be explained by addressing individual variables (e.g., comorbidity) as well as environmental variables (e.g., quality of the dwelling unit). Study II data offer evidence that older adults suffering from blindness since their early childhood are better adapted than older adults who experienced blindness only in their later years. Study III shows that visually impaired institutional residents reveal deficits in everyday competence and social contacts as contrasted with their unimpaired counterparts, whereas no difference is observed in the domain of subjective well-being. CONCLUSIONS: All three studies point to the negative impact of age-related visual impairment on emotional and behavioral adaptation in later life. This highlights the need for a whole range of rehabilitative efforts, including psychosocial elements, which are described in the final part of this article.

Activities of Daily Living↗
PubMed1998

[Interventional gerontology in German-speaking countries: a social and behavioral science assessment].

This work is aimed at reviewing 20 years of gerontological intervention research within the social and behavioral domain in German speaking countries. Only controlled studies based on adequate measurement instruments are considered. Literature analyses reveal that the issue of cognitive intervention research is well-covered, underlining clear positive training effects in intellectual performance and memory. Also, studies on the limits of mental capacity represent a highlight of German cognitive training research. Another bunch of studies underlines the potential of different intervention to enhance independence in day-to-day function, social activity, and subjective well-being. Positive effects in self-concept, personal control, and attribution style are as well reported. A general discussion of this body of work leads to suggestions for future research priorities.

Adaptation, Psychological↗
PubMed1998

[Every day competence: a construct in search for an identity].

The goal of this paper is to contribute to conceptual issues associated with the construct of everyday competence. After the description of reasons for the increased attention which everyday competence has found within gerontology, the first section of this work serves to shed light on six research traditions with relevance for everyday competence: (1) Research on everyday cognitive processes, (2) ADL/IADL research, (3) leisure time research, (4) coping research, (5) time budget research, and (6) ecological gerontology research. In the second section, two influential models of everyday competence, namely those of Margret Baltes and Sherry Willis, are discussed. Finally, an integrative conception of everyday competence, which is aimed to combine aspects of the six research traditions with elements of the two models of everyday competence, is suggested.

Activities of Daily Living↗
PubMed1992

The dependency-support script in institutions: generalization to community settings.

This study tested the generalizability of the dependency-support script, a behavioral system describing and explaining dependent behaviors of the institutionalized elderly. A comparative study with 22 community-dwelling elderly was conducted, which identified typical interaction patterns between the elderly and family members or home health nurses. The dominant interaction pattern in the community setting, too, was the dependency-support script. In addition, however, a significant social response to independent self-care behavior was observed, which created a highly ambivalent response contingency. Independent behaviors were followed about twice as often by an incongruent (dependence-supportive) than by a congruent (independence-supportive) response. Expectations of incompetence and of the helping role are offered as explanations.

Activities of Daily Living↗
PubMed1991

Dependence in the elderly from an interactional point of view: verbal and observational data.

Dependence in the elderly was investigated from an interactional point of view. Observations as well as verbal data of the elderly and professional caregivers were considered. Samples consisted of 14 elderly people receiving regular home health care (M = 78.9, SD = 6.3 years) and 16 elderly people receiving regular nursing home care (M = 81.4, SD = 7.5 years). Results showed a strong tendency toward independence in the elderly. Sense of control in the self-care interactions observed was higher in the home health care group than in the group receiving nursing home care. Division of the elderly into subgroups with high, medium, and low perceived self-efficacy showed that the elderly high in self-efficacy were more independent in terms of observed self-care. Causal explanations of the elderly's competence and their nonuse of competence were significantly different between the elderly and staff.

Activities of Daily Living↗
PubMed1990

The daily life of elderly Germans: activity patterns, personal control, and functional health.

Aging processes are often described as an interacting system of personal and environmental conditions. It is surprising, therefore, to find an almost complete lack of reliable data describing the everyday lives of the elderly in terms of external components such as type of activities, locations, and companionship. The present study is an attempt to remedy this lack of information and thereby provide a basis for a better understanding of aging processes. Forty-nine mobile and independently living elderly people (mean age = 72.7) recorded their daily activities over a period of 6 months. During a randomly selected week per month they kept a prestructured diary about what activities they engaged in, where, when, and with whom. In addition, functional health and personal control beliefs were assessed. The diaries were coded along 37 activity categories (inter-rater reliability estimated via Cohen's Kappa: M = .93), 5 categories for location and 6 categories for companionship. The major findings can be summarized as follows: The typical activity profile is characterized, in terms of highest frequency, by obligatory activities. In terms of time, however, they make up but little more than half of the day, predominantly the mornings. Afternoons and evenings, were mostly spent with leisure activities. The paths of daily lives of the elderly were marked by two geographic domains. The first and foremost is the home, followed by public places. With regard to the relationship between activities and personal control, we find a close relationship particularly when functional health is low.(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMedDate not supplied

[Disability in the population of the elderly: results of a field study].

The concept of disability has gained importance in geriatric research and practice. There is now insight into the impairing function not only of illness but also of its consequences for an autonomous and satisfactory way of life. The aim of the study reported here was to elucidate the relationships of old age disabilities and other potentially important factors such as physical and psychiatric impairments as well as demographic characteristics. A representative sample of old people in an urban community (Mannheim, F.R.G.) was the target population of this study. The results demonstrate--above all--a significant correlation between reduction in motor skill capacity and disability in carrying out activities of daily living. Psychiatric impairment--in particular organic psychiatric disorders--play a role as well. Old people with both physical and psychiatric impairments are the most disabled of the sample and must be considered a high-risk group for the loss of independent living.

Activities of Daily Living↗
PubMedDate not supplied

[Social stress, psychiatric disease and physical impairment in old age: results of a field study].

As part of an epidemiological study of elderly people in Mannheim (FRG), the associations between social situation, psychiatric illness and physical impairment were investigated. For this purpose, social interview data and data from a medical-psychiatric interview, based on a representative sample of residents of 7 city districts (N = 350), were analyzed. Social situation was defined by 3 aspects of the life situation: unfavorable housing conditions, low socioeconomic status and "objective" and "subjective" social isolation. Psychiatric illness and physical impairment were found significantly more often among people with unfavorable housing conditions. Furthermore, the frequency of psychiatric illness and physical impairment increased with declining social class membership. Interestingly, this negative association disappeared for psychiatric illness when physical impairment was partialed out. Finally, "subjective" isolation was associated highly significantly with psychiatric illness and physical impairment; for "objective" isolation however these relationships did not exist. The results suggest that each of the factors except "objective" isolation contains a risk potential for psychiatric illness and physical impairment. Further research is needed to answer questions concerning interactional and cumulative effects of the 3 risk factors.

Aged↗