A health belief interview for clinical geriatrics.
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Biomedical subjects
Publications and source records attributed to W Rakowski.
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Current urbanization trends in Poland are analyzed. "In the first part of the article the author presents the changes in the settlement network in 1945-1980 together with the process of concentration of population. In the second part he describes the influence exerted by the big and average towns." (SUMMARY IN ENG AND RUS)
The future orientation that health care providers have toward old age has been proposed as one factor that contributes to unfavorable perceptions of older patients. Two samples of students from a dental hygiene program (n1 = 145; n2 = 100) were questioned about their general attitudes toward older people, older people as patients, their own future, the future for older adults, and about their social/familial contact with the elderly. Discriminant function analysis supported the importance of both views of the future and social/familial background for general attitudes and perceptions of patients.
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The prevalence in later life of long-term, chronic conditions requires that researchers and clinical professionals become sensitive to the temporal context of older persons' personal and health-related perceptions. A sample of patients at a geriatric ambulatory clinic responded to a questionnaire sent prior to their appointment. The present report focuses on expectations regarding future health and treatment, general personal future projection, and perceptions of current health. Present self-rated health status and future projection were significant associates both of anticipated future health and treatment expectations. However, questions directed toward when treatment benefits were expected to begin and for how long treatment might last were characterized by few predictors. Indications of optimism and uncertainty about future health and treatment were both represented, although neither general optimism nor general uncertainty appeared in a large segment of the sample. Results suggest the salience of future perspective for older adults in the health care setting, and the complexity which may be encountered as treatment progresses.
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Patients aged over 60 or older from the practice of a private physician (n = 32) and from a geriatric outpatient clinic (n = 132) responded to a questionnaire designed to assess perceived present and future health, treatment expectations, and general future projection. Of interest was the extent to which present health, as measured by a brief life-graft technique, might be predictive of perceptions in these other areas. Results from two samples were consistent in suggesting that present health ratings were related to anticipated future health, general future projection, and certain treatment expectations. However, expectations of when benefits from treatment would begin, and of the probable duration of treatment, were not predicted in either sample. The life-graft technique seems useful for practitioners' interactions with older patients and for understanding these patients' extended view of their health.
This study focused on predictors of consistency and inconsistency in health and treatment expectations among 77 new patients (mean age, 73) at a geriatric outpatient clinic. Just before their first appointment, and again one week afterward, the patients were asked about their overall health status, their specific illness complaints, their reasons for visiting the clinic, and their expectations regarding treatment and the future outlook. Few predictors of consistency were found for such outcome measures as the number of health problems reported, present and future health status, and the duration, difficulty and benefits of treatment. Inconsistency and uncertainty were more evident in these geriatric outpatients' perceptions, especially among those with self-rated poor health and mobility. This study emphasizes: 1) the importance to the treatment context of geriatric patients' inconsistencies about their health, and 2) the additional burden clinicians must bear in dealing with such discrepancies.
Attitude instrument development remains a necessary task in aging research, for the eventual explication of attitude-behavior relationships. The present report describes initial development of the Aging Opinion Survey, an instrument based upon a multidimensional view of attitudes towards aging and the elderly. After identifying substantive attitudinal content areas, an initial 120-item pool was constructed, balanced across referent groups and direction of wording. Pilot analysis eliminated sixty items with minimal variances. Administration of the reduced item set to a subsequent sample of 200 gerontological practitioners and students produced four meaningful factors. Poor items were again eliminated and replacements constructed. Another administration (n=226) again produced four meaningful factors, three of which met the criterion of reliability: (1) Stereotypic age decrement, (2) Personal anxiety toward aging, and (3) Social value of the elderly. These scales appeared to reflect peer, personal, and generalized-elderly referents, respectively. Development and refinements of attitudes scales such as the Aging Opinion Survey are necessary elements for proceeding beyond the current theoretical and empirical difficulties in gerontological attitude literature.
The dimension of time perspective for extension of personal future was examined as it may be affected by response format and coding procedures. A total of 75 undergraduate students responded to a questionnaire containing one of three formats for reporting anticipated future life-events, varying in the structure imposed on responding. Temporal estimates of life-event occurrence were coded using two procedures, each of which permitted a near and a far value. Analyses suggest that the greatest degree of caution should occur in considering the representativeness of far estimates of extension provided under an open-event format. While coding procedures each produced a significant near/far difference, cross-procedure comparisons were not as impressive, despite also being significant. Questions can therefore be raised regarding techniques for obtaining time perspective data and preparing them for analysis.
The degree of experimental and quantitative detail which can be imposed on older adults' temporal experiences remains a significant area for investigation. This paper surveys material related to this general area of study, taking primarily a psychological focus. Review of this literature suggests that while a basic future time orientation is not significantly affected in later life, older adults are at-risk of developing a less extended and less full personal future. However, research has been almost exclusively cross-sectional,, and our empirical knowledge concerning the functional impact of such changes, should they occur, is minimal. In addition, although several correlates of older adults' future time perspective have been reported, normative directions of causal relationship have not been determined. Consequently, while much of our data are varied, interesting, and insightful, they are at present difficult to organize or apply. Research should be pursued on several fronts, including prospective designs, the use of time perspective as a predictor and outcome variable, model development, and close association with temporal concepts in social gerontology.
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Age differences in attitudes toward aging were investigated as a function of a 3-hour training program with 322 women (18-74 years) from various geriatric health care and social service contexts. Using a quasi-experimental pre- and posttest design, sites were randomly divided into initial experimental and control groups, with all control participants receiving training following the research program. Results indicated few instances of unfavorable attitudes toward aging in any age group, with younger women evidencing less cynicism toward aging, less social distance from the aged, and slightly less stereotyping. Training appeared to result in less cynicism, stronger endorsements of family and public responsibility, and slightly greater anxiety. No Age X Pretest/Posttest interactions were found. The results are discussed in terms of their implications for service provider-client interaction, the correspondence of attitudinal and behavioral change, and appropriate instruments for assessing program impact.