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At least 1,063 records · Page 59Linked to original sources
PubMed2003

Identifying older people at risk of abuse during routine screening practices.

OBJECTIVES: To examine the association between various characteristics of community-based older people and a constructed measure of potential elder abuse. DESIGN: Cross-sectional design. SETTING: Public community-based long-term care programs in Michigan. PARTICIPANTS: Individuals aged 60 and older seeking home and community-based services in Michigan between November 1996 and October 1997 (N = 701). MEASUREMENTS: Data were collected using the Minimum Data Set for Home Care (MDS-HC) assessment. The dependent variable is a constructed measure of potential elder abuse reflecting physical and emotional abuse and neglect. Independent variables include demographic characteristics; diagnoses; behavioral measures; and cognitive, physical, and social functioning. RESULTS: Several measures of social support and social function were strongly associated with the signs of a potentially abusive environment: brittle support (odds ratio (OR) = 3.5, 90% confidence interval (CI) = 1.5-8.1), older person feels lonely (OR = 2.4, 90% CI = 1.3-4.5), and older person expresses conflict with family/friends (OR = 2.3, 90% CI = 1.2-4.3). Home care participants' alcohol abuse, psychiatric illness, lack of ease interacting with others, and short-term memory problems were also significantly associated with the signs of potential elder abuse. CONCLUSIONS: The results of this study suggest that the signs of potential elder abuse are associated with a diminishing social network and poor social functioning, although some characteristics of the older person's health are contributing factors. Improved understanding of the link between those characteristics and potential abuse will help healthcare providers, case managers, and others identify older people at high risk of abuse.

Activities of Daily Living↗
PubMed1994

Motherhood after traumatic spinal cord injury.

The present study includes all women with a traumatic spinal cord injury in Sweden who became pregnant and delivered live infants during 1980-1991. This group comprises six tetraplegic and 20 paraplegic patients, all confined to a wheelchair. During the above mentioned period the patients had delivered a total of 47 children. The study evaluated parental ability and quality of family life as regards interpersonal relationships, family relationships, social integration, recreational interests and demand for external assistance. An individual standardised interview was performed with all patients. In addition a standardised questionnaire was sent to all spouses (n = 20) and to all children above 10 years of age (n = 10). All 26 patients participated, 18 spouses completed and returned the questionnaires and all children took part in the study. We found an overall favourable outcome as regards the parameters evaluated. The families seem to live a rich and complete family life with very little demand for external help. They report a well functioning social network and seem socially integrated both as individuals and as families. To conclude, the study indicates that there is no reason to question females with an SCI in their roles as parents. The spinal cord injury per se, in females, thus does not preclude the possibility of having a family and caring for children adequately.

Activities of Daily Living↗
PubMed1999

Psychiatric nursing for promotion of mental health and prevention of depression in the elderly: a case study.

The aim of this case study was to describe and analyse the basic pre-conditions for an intervention programme focusing upon mental health promotion and prevention of depression in an elderly community group and to discuss the psychiatric nurse's community-oriented health promotion work. The intervention programme, which was led by a psychiatric nurse, was built on intersectorial co-operation between public and voluntary organizations, development of social networks to promote social support, and target group participation. The nurse's function in the community-oriented work was to act at the individual, group and society level, as well as to mobilize resources among individuals and organizations, in order to create a favourable interaction, resulting in health and empowerment for the individual. Pre-conditions for leading this work were: knowledge of health and mental all health among the elderly, investigation methodology, knowledge about the local society, as well as pedagogical, supervisory and social competence.

Aged↗
PubMed1999

A model to explain the relationship between sexual abuse and HIV risk among women.

This paper presents a model developed to advance the understanding of the relationship between sexual abuse and HIV risk among women. It is proposed that the relationship is mediated by many of the long-term sequelae of sexual abuse. The process of mediation is believed to occur through various causal pathways propelled by specific underlying mechanisms that increase the likelihood of HIV risk. The following causal pathways are proposed: (1) initiation of and/or increasing reliance on drug use as a method of coping with the sexual abuse experience, (2) problems with sexual adjustment related to sex risk taking, and (3) psychopathology (e.g. depression) which increases the likelihood of an individual participating in HIV risk behaviours. These hypothesized pathways are based on the characteristics and behaviours of individuals with histories of sexual abuse and do not take into account the influence of the individual's social environment. Increasingly, evidence suggests that understanding the social context of HIV risk is crucial to the development of preventive interventions. Therefore, a final pathway is explored which suggests that specific social network characteristics (e.g. network membership type, social support, and social isolation) influence HIV risk exposure opportunities among women with sexual abuse histories.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Unaccompanied young adult refugees in Sweden, experiences of their life situation and well-being: a qualitative follow-up study.

OBJECTIVE: In the late 1980s unaccompanied children began arriving in Sweden. Many of them were teenage boys who had been called up or were at risk of being called up for military service in a war in their home country. Others had fled their homeland for political reasons. The purpose of the study was to describe how unaccompanied young adult refugees experienced their own life situation and well-being seven years after they had gained permanent residency. DESIGN: The original sample comprised 34 unaccompanied refugees who at 16-26 years of age were placed in a municipality in Sweden. Eleven of these participated in the present second follow-up study after a mean of 10 years in their new country. Qualitative interviews were conducted and analysed according to Giorgi's descriptive phenomenology. RESULTS: Most of the participants expressed contentedness with their lives and had begun to adjust to their new country. They had a social network of friends from the same ethnic group, and their Swedish contacts were mostly workmates. A few felt lonely and expressed despondency and depression. They were single and reported a small network and limited social support. One participant described symptoms of post-traumatic stress disorder (PTSD), even after 11 years in the new homeland. CONCLUSION: It appears that most of the participants in the present follow-up study had worked through the problems that typically face refugees and had begun adapting to their new country, while a few still felt lonely and did not feel part of the community. The results may be affected by non-response. Those who dropped out may live with more distress in everyday life and suffer depression more frequently.

Adult↗
PubMed2005

Emotional health of black and white dementia caregivers: a contextual examination.

The aim of this study was to examine emotional health (e.g., depressive symptomatology) among 295 Black and 425 White dementia caregivers. I selected caregivers from the Resources for Enhancing Alzheimer's Caregivers' Health (REACH) data set. I used regression analysis to examine racial differences and the relationship between the contextual variables and depressive symptoms. Overall, age, size of social network, satisfaction with social activities, financial difficulty, positive aspects of caregiving, stressfulness appraisal, and health problems were related to depressive symptoms. Contextual factors were not homogeneous across race; the number of memory and behavior problems of the care recipient was associated with more reports of depressive symptoms among Black caregivers only. Results suggest the importance of examining various contexts surrounding the actual environment in which Black and White dementia caregivers provide care.

Activities of Daily Living↗
PubMed1993

Aging parents of adults with disabilities: the gratifications and frustrations of later-life caregiving.

Using a stress process model, we investigated the impact of later-life caregiving on 105 mothers of adult children with mental illness and 208 mothers of adult children with mental retardation. As hypothesized, mothers of persons with mental illness reported higher levels of frustrations and lower levels of gratifications. Whereas the adult child's behavior problems were the strongest predictor of maternal gratifications, the adult child's diagnosis was the strongest predictor of maternal frustrations once all other factors were controlled. In addition, the size of the mother's social network, the family social climate, and the child's participation in an out-of-home program were associated with the effect of caregiver stress.

Adult↗
PubMed2005

Evaluating the effectiveness of community-based dementia care networks: the Dementia Care Networks' Study.

PURPOSE: The Dementia Care Networks' Study examined the effectiveness of four community-based, not-for-profit dementia networks. The study involved assessing the relationship between the types of administrative and service-delivery exchanges that occurred among the networked agencies and the network members' perception of the effectiveness of these exchanges. DESIGN AND METHODS: With the use of a case-study method, the evolution, structure, and processes of each network were documented. Social network analysis using a standardized questionnaire completed by member agencies identified patterns of administrative and clinical exchanges among networked agencies. RESULTS: Differences were found between the four networks in terms of their perceptions of service-delivery effectiveness; perceptions of administrative effectiveness did not factor significantly. Exchanges between groups of agencies (cliques) within each of the four networks were found to be more critical than those between individual agencies within each network. IMPLICATIONS: Integration-measured by the types of exchanges within as opposed to across networks-differentiated the four networks studied. This research contributes to our understanding of the use of multiple measures to evaluate the inner workings of service delivery and their impact on elder health and elder health care.

Aged↗
PubMed1994

Resources and supports for mothers with severe mental illness.

Over the past 20 years, community mental health services have enabled individuals with severe mental illness (SMI) to spend more time in the community and to have greater opportunities to face normal developmental life tasks. Currently, women with SMI appear to be as likely to have children as women in the general population. Although these mothers tend to be single parents, often live in inadequate housing, have small social networks, and lack social and emotional supports, they have received little treatment attention. This article presents a systematic review of literature published in the past decade that describes interventions for mothers with SMI. These interventions are critiqued, and implications for future interventions are drawn using a psychiatric rehabilitation framework.

Adult↗
PubMed2005

Information-theoretic approach to network modularity.

Exploiting recent developments in information theory, we propose, illustrate, and validate a principled information-theoretic algorithm for module discovery and the resulting measure of network modularity. This measure is an order parameter (a dimensionless number between 0 and 1). Comparison is made with other approaches to module discovery and to quantifying network modularity (using Monte Carlo generated Erdös-like modular networks). Finally, the network information bottleneck (NIB) algorithm is applied to a number of real world networks, including the "social" network of co-authors at the 2004 APS March Meeting.

Algorithms↗
PubMed1993

Loneliness, depression, and social support of patients with COPD and their spouses.

Thirty clients with chronic obstructive pulmonary disease (COPD) and their spouses were interviewed to examine differences in the relationships among loneliness, depression, and social support. Data were collected during structured in-home interviews using the UCLA loneliness scale, the Center for Epidemiological Studies depression scale, and the social support questionnaire. The clients and spouses did not differ significantly on measures of loneliness and depression, with mean scores for both groups higher than those in other comparable groups. Spouses, however, tended to be a little lonelier than clients, and clients tended to be a little more depressed than spouses. The two groups were also similar with respect to the number of people in their social networks but different as to network composition. Spouses were less satisfied with their networks than clients. Social support satisfaction was linked to loneliness and depression for clients but not for spouses. Results of the study suggest that community nurses working in home settings must be sensitive to clients' and spouses' psychologic reactions to COPD, which may be expressed in feelings of loneliness and depression.

Aged↗
PubMed2001

Does social support buffer functional decline in elderly patients with unipolar depression?

OBJECTIVE: This study tested whether social support protects against functional decline, either generally or selectively, in the most severely depressed elderly patients undergoing treatment for major depressive disorder. METHOD: In a prospective cohort study design, 113 patients with incident and prevalent unipolar depression were followed for 12 months while they were undergoing naturalistic treatment. Outcome measures included performance on basic and instrumental activities of daily living; predictor variables included Hamilton Depression Rating Scale scores and four domains of informal social support. The analysis employed multivariable ordinary least squares regression models. RESULTS: Improved scores on instrumental activities of daily living and stable scores on basic activities of daily living characterized the subjects. In adjusted analyses, instrumental social support provided marginal protection against worsening performance on instrumental activities of daily living, which were primarily a function of baseline depression severity. Large social networks, more frequent social interaction, and the perceived adequacy of social support played a modest buffering role against declines in performance on basic activities of daily living among the most depressed elderly patients. CONCLUSIONS: Instrumental support was generally protective against worsening performance on instrumental abilities of daily living among elderly patients with recurrent unipolar depression. Subjective and structural dimensions of social support protected the most severely depressed elderly patients against the loss of basic maintenance abilities.

Activities of Daily Living↗
PubMed1995

[Factors associated with increased diabetes burden in elderly diabetic patients].

To define the factors that determine the increased burden of diabetes in elderly diabetic patients, we examined the relationship between the Elderly Diabetes Impact Scales (EDIS) and physical or social factors in 383 elderly outpatients aged over 60 years old who answered QOL questionnaires by professional interviewers. The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry) and total EDIS scores were calculated by summing up the 4-point scores of 37 questions. The EDIS scores were highest in patients who received insulin therapy. In univariate analysis, high EDIS scores were significantly associated with high HbA1c, low Roken ADL score, and the presence of retinopathy or neuropathy. Among social factors, leisure activities, housework or jobs, social network, and positive social support were significantly associated with low EDIS scores, while negative social support was associated with high EDIS scores in elderly diabetic patients. Multiple linear regression analysis revealed that age (younger), sex (women), low ADL (or diabetic complications), insulin therapy, low positive social support, high negative social support, economical dissatisfaction, and the low adaptative feeling of diabetes were significant and independent determinants of a high burden in diabetic patients indicated by EDIS scores in Japanese elderly diabetic patients.

Activities of Daily Living↗
PubMed2003

Cancer prevention in underserved African American communities: barriers and effective strategies--a review of the literature.

African Americans suffer significantly more cancer morbidity and mortality than the white population. In order to decrease this differential, it is critical to understand the particular barriers to health and health care that underserved African Americans face. It is also important to identify the critical components of effective cancer prevention programs for this population. The barriers that impede care for underserved African Americans have been identified as: 1) inadequate access to and availability of health care services; 2) competing priorities; 3) lack of knowledge of cancer prevention and screening recommendations; 4) culturally inappropriate or insensitive cancer control materials; 5) low literacy; 6) mistrust of the health care system; and 7) fear and fatalism. Effective programs must incorporate community participation, innovative outreach, use of social networks and trusted social institutions, cultural competence, and a sustained approach. Programs that include these strategies are much more likely to be effective in reducing cancer incidence. Cancer ranks second only to cardiovascular disease as the leading cause of death in the United States. For the majority population, cancer incidence and prevalence have declined in recent years and cure rates for certain cancer diagnoses have improved. This can be attributed to progress in the development and implementation of prevention, early detection, and treatment strategies. However, despite these gains, medically underserved African American populations have not fared as well. When African American-white mortality rates are compared, African Americans are 1.3 times more likely to die of cancer than the general population. Data from the Bureau of Health Information, Wisconsin Department of Health and Family Services indicate that from 1996 to 2000, cancer accounted for 33% of deaths in African Americans aged 45-64 and 34% of deaths for those aged 65-74. To decrease the disparities in cancer morbidity and mortality between the African American and white population, it is critical to understand the particular barriers to health and health care that African Americans face. This paper is a literature review of the barriers that low-income African American populations confront in obtaining needed cancer prevention and detection and the characteristics of programs that have been effective in reaching these populations.

Black People↗
PubMed2002

[Role of social epidemiology in the evaluation of psychosocial health determinants].

The relationship between social factors and health status is well known in medical sciences. However, the importance of methods implemented in the assessment of psychosocial health determinants has been addressed only recently. The combined perspective of epidemiology and sociology showed the need for the new science called social epidemiology. The aim of this work was to review the results of studies on effects of psychosocial factors on increased risk of disease and death. The association between socioeconomic position and health is well established. There is a direct relationship--the better the socioeconomic position the better health. The socioeconomic relative inequalities not only the absolute differences between socioeconomic groups influence health. The relationship between unemployment and increased mortality has been reported in western industrialized countries. Classical longitudinal studies of unemployed cohorts showed that unemployed men had higher mortality. Social epidemiology has also revealed the influence of social relationships on mortality. The theory of social support and social network buffer links social ties to less morbidity, mortality and better functioning. Randomized clinical trials positively tested the role of social support in preventive medicine, especially for secondary prevention of cardiovascular diseases. It is critical to adopt findings of social epidemiology by health care policy. The epidemiological investigations and experimental research have shown how psychosocial interventions and economic policies are central to improving population health.

Attitude to Health↗
PubMed1986

[Depressive symptoms and the utilization of professional care by the elderly living at home].

In Geleen, a survey was held among the total population aged 75-84 years on activities of daily living, housekeeping performance and use of professional and lay care. Out of 860 respondents to this postal questionnaire 334 were selected for a semistructured interview. Two groups with the same physical limitations, one using professional care and the other not, were compared on several characteristics. These characteristics were: 1. mental state (depression, dementia); 2. social network; 3. social-economical situation; 4. housing conditions. By means of multivariate analysis, associations between these characteristics and utilisation of professional care were identified. A major finding of the study was a twice as high prevalence of depression among users of professional care compared to non users. If depression is a causative factor in the demand for professional care, early detection and prevention of depression might be important in reducing professional care demand. Recognising depression in applicants for professional care may assist in adjusting the content of care.

Activities of Daily Living↗
PubMed1983

[Social environment of the psychic crisis situation].

The social environment in a psychic crisis situation is of great importance for the mode of action chosen to cope with the crises. Using suicide and the different characteristics of persons, who successfully attempted or completed suicide, as an example, different strategies are presented. Three questions of special importance are mentioned: 1. the question, as to what triggered the crisis; 2. the question of the social network and the quality of relationship and 3. the question, when the affected person and his social network were confronted with the problems.

Social Environment↗
PubMed1993

Life events and social support in suicide.

In a conceptual framework of suicide process, literature on life events and social support in suicide is reviewed. Few studies have centered on these issues, and the existing research has many methodological ambiguities. However, it can be concluded that life events play an important role in suicide process as risk and precipitating factors. The findings on disintegration of social networks and poor social support indicate lack of protective factors. Implications for future research are discussed. Further research focusing on more specific questions on the role of life events and social support as well as their interactions is needed.

Humans↗