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Biomedical subjects

R M Coe

Publications and source records attributed to R M Coe.

At least 37 records · Page 2Linked to original sources
PubMed1986

Further assessment of the reliability and validity of a Nutritional Risk Index: analysis of a three-wave panel study of elderly adults.

This paper reports on the further assessment of the reliability and validity of a short (16-item), portable method for assessing nutritional risk which is easily administered in the typical social survey setting. Data were obtained from a three-wave panel study of 401 randomly selected, noninstitutionalized elderly persons (age 65 and over) in St. Louis. Reliability was assessed by both internal consistency and test-retest methods. Reliability coefficients (internal consistency) of .603, .544, and .515 were obtained at T-1, T-2, and T-3, respectively. Cross-panel intercorrelations (test-retest) ranged between .67 and .71. Validity was assessed using factor analysis and various outcome measure comparisons for those at risk versus those not at risk. A five-factor orthogonally rotated solution explained 47.9 percent of the variance in the 16 items. Individuals with higher risk scores had significantly poorer health as measured by other standard indexes, and used significantly more health services than those with lower risk scores. These results underscore the potential of the Nutritional Risk Index (NRI) as a screening device for use among the elderly.

Activities of Daily Living↗
PubMed1985

Correlates of change in subjective well-being among the elderly.

This study examines two related issues concerning the subjective well-being of elderly adults: change over time and correlates of that change. Data come from a three-wave panel study of 401 elderly residents in St. Louis. Residualized change score regression analyses indicate: there is change in subjective well-being over 4-5 months and over 12 months; the 4-5 month and 12 month changes are remarkably similar; the effect of subjective well-being over time indicates regression to the mean; and, only socioeconomic status is a significant predictor of change in subjective well-being (net of the effects of subjective well-being itself). The implications of these results for our understanding of subjective well-being in the elderly are discussed, as are the policy implications of the positive effect of socioeconomic status on changes in the subjective well-being of the elderly.

Aged↗
PubMed1985

Veterans' and nonveterans' use of health services. A comparative analysis.

This study compares the use of health services by veterans with that by nonveterans; compares the use of health services by veterans from different service cohorts with each other; and examines the correlates of veterans' use of the VA health care delivery system. After adjusting for differences in the predisposing, enabling, and need characteristics, there were virtually no meaningful differences in the use of health services between veterans and nonveterans. This suggests that health care planning within the VA can proceed similarly to health care planning for the civilian population, albeit taking into consideration the significant difference in the sex distribution between the two populations. Virtually no meaningful or consistent veteran cohort effects on the use of health services were found. This suggests that health care planning within the VA may proceed without regard to changes in the nature of the veteran cohort structure. Finally, although there was a strong and obvious effect of service-connected disabilities (high-priority eligibility due to health status) on the use of the VA health care delivery system for veterans, there was no effect of being 65 years of age and older (high-priority eligibility due to age) on the use of the VA. Aside from service-connected disabilities, limited access to other health care delivery systems was the major factor behind the demand for VA care.

Aged↗
PubMed1984

Measurement of the global and functional dimensions of health status in the elderly.

Data from a two-stage random sample of 401 noninstitutionalized elderly individuals residing in 18 census tracts in south-central metropolitan St. Louis were used to examine the relationships among seven measures of health status. Factor analyses revealed two pristine dimensions: (a) a global health status dimension, on which perceived health status, nutritional risk, perceived sensory functions, and mental health all load significantly; and, (b) a functional dimension on which the Activities of Daily Living, Instrumental Activities of Daily Living, and mental orientation measures all load significantly. These two factors explain 56% of the variance in the seven health status measures, and, using an oblique rotational procedure, they were found to be correlated only modestly (r = .37). The implications for the measurement of health status of elderly adults as well as the use of such measures in predicting health services utilization are discussed, and recommendations for the inclusion of items tapping both dimensions in future studies are presented.

Activities of Daily Living↗
PubMed1984

Physician and hospital utilization among noninstitutionalized elderly adults: an analysis of the Health Interview Survey.

Data on 15,899 noninstitutionalized, elderly adults taken from the 1978 Health Interview Survey were used to assess the effects of the predisposing, enabling, and need characteristics on the volume of physician and hospital utilization. These were measured three ways: the actual number of visits (nights), and truncated and logarithmic transformations of that actual volume. Multiple regression analyses explain 3.9% to 21.3% of the variance in physician utilization and 5.1% to 9.4% of the variance in hospital utilization. The unique contributions of the need characteristics account for 56.8% to 66.7% of the variance explained in physician utilization and 74.5% to 77.7% of the variance explained in hospital utilization, suggesting an apparently equitable system is operative in elderly adults' use of health services. The effects of the three methods of coding physician and hospital utilization on the significance of the regression coefficients and the magnitude of the R2 values were examined and their implications are discussed.

Aged↗
PubMed1984

Strategies for obtaining compliance with medications regimens.

Case examples of doctor-patient interactions are used to examine educational strategies employed by physicians to obtain compliance with medication regimens from elderly patients. The problems addressed by the physicians included the complexities of pharmaco-therapy in the elderly (the patients each presented multiple problems involving the use of multiple medications), the limited understandings of the drugs showed by patients and their relatives; and the issue of compliance with instructions. Educational strategies that were effective are described.

Adult↗
PubMed1982

Faculty resources for teaching geriatric medicine.

Self-administered questionnaires were sent to all faculty and staff members of the departments of internal medicine and psychiatry in a school of medicine. The questionnaires asked for information about personal characteristics, practice characteristics, and interest in teaching geriatrics. Included also were measures of knowledge about aging and attitudes toward the elderly. Responses were received from 25 per cent of the faculty. Results indicated that 40 per cent wanted no involvement in teaching geriatrics. Of the remainder, most preferred a consultant's role on a clinical service. Despite extensive experience with elderly patients, respondents showed modest scores on knowledge, but there was little stereotyping of elderly patients. Implications for establishing a training program in geriatrics are discussed.

Adult↗
PubMed1982

Patterns of change in adolescent smoking behavior and results of a one year follow-up of a smoking prevention program.

A smoking prevention program for adolescents conducted in two public middle schools focused on resisting peer pressure to smoke and understanding the intent of commercial cigarette advertising. One class in each school participated in the program group and one served as a control group. The program consisted of eight sessions and was conducted by first-year medical students. Data on smoking behavior and related information were obtained from self-administered questionnaires at baseline, at the conclusion of the program, and one year later. One year after the program was concluded, the proportion of non-smokers was higher among those who had participated in the program than among the controls. This suggests that routine implementation of smoking prevention programs in conventional school settings may be productive in reducing the prevalence of cigarette smoking.

Adolescent↗
PubMed1982

Attitudes and health promoting behavior of medical and law students.

An entering class of medical students is compared with an entering class of law students on attitudes toward self-responsibility for health and reported health behaviors. Students' health behavior patterns are contrasted with those of practicing physicians and lawyers. Data were collected by self-administered questionnaires. Results indicated that medical students were stronger on self-responsibility and also reported more often engaging in health promoting behavior than law students. The same pattern of differences was reported for practicing physicians and lawyers.

Adult↗
PubMed1980

Cigarette smoking among medical students.

A survey of first and second year medical students at Saint Louis University revealed that only 6 per cent were current cigarette smokers. This represents a continuation of a downward trend in the percentage of smokers among American medical students as reported in earlier, independent surveys. Implications for improved health status and for better preventive care for patients by these future physicians are discussed.

Adult↗