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PubMed1993

Measurement of need for assistance with daily activities: quantifying the influence of gender roles.

This research quantified the contribution of traditional gender roles to patient-reported receipt of assistance with personal care activities, housework, cooking, shopping, transportation, and administrative activities among a sample of 629 cancer patients with advanced disease who were undergoing outpatient treatment. Approximately 80 percent of male patients and 30 percent of female patients attributed help received with household tasks to longstanding division of labor. This response was particularly common among married men and did not differ by age or educational status. However, available morbidity indicators suggest that approximately one-third of these patients actually were functionally impaired, despite attribution to gender role expectations. We adjusted estimates of need for assistance to avoid overestimation due to role-related help, and a second time to avoid underestimation due to underreporting of physical inability to perform a task alone. After making these adjustments, male patients' level of need for assistance with traditionally female-associated tasks was reduced by approximately 50 percent.

Activities of Daily Living↗
PubMed1993

Are blacks more likely than whites to receive and provide social support in middle and old age? Yes, no, and maybe so.

Differences in the social support transactions of White and Black adults were investigated using data from the 1987/88 National Survey of Families and Households. Multivariate models were estimated to identify differences between Whites and Blacks in the likelihood that they provided and received instrumental and emotional support. Most importantly, we examined, separately for men and women, variations in Black-White differences from mid-life to old age. Results indicated that, overall, Blacks were no more likely than Whites to provide and receive both types of social support. In fact, Black women were less likely than White women to provide instrumental support to others. However, in old age, Black women were more likely to receive instrumental support and about as likely as White women to provide such support. These findings suggest that when comparing the informal support activities of White and Black adults, race needs to be considered in the context of gender and stage of life.

Black or African American↗
PubMed1993

Concerns regarding adult children's assistance: a comparison of young-old and old-old parents.

This study describes differences between young-old (ages 60-74) and old-old (ages 75-90) parents' concerns regarding assistance provided by adult children. Old-old parents expressed more concern regarding amounts of help than did younger parents; there were no age differences in levels of concern regarding help outcomes. The percentage of children receiving parents' help and reliance on formal services predicted level of concern regarding help outcomes for the young-old parents, but not the old-old parents. Familism values and the extent of help received predicted level of concern regarding help amounts for the old-old parents, but not for younger parents. Implications for interventions to minimize parents' concerns and for further study of family assistance to the older people are discussed.

Aged↗
PubMed1991

Time spent caregiving and help received by spouses and adult children of brain-impaired adults.

Caregivers for brain-impaired adults differ in living arrangements, amount of time spent giving care, and assistance received from family and friends and from paid help depending on their kin relationship and employment status. Spousal caregivers devote large amounts of time to caregiving, and husbands spend no less time than wives. Most caregivers receive little assistance from other family members and friends, but husbands receive more than others. Employed spouses receive more paid help than those without jobs, but employment does not affect the amount of paid help received by adult daughters.

Adult↗
PubMed1996

Older adults as a community resource: results from the National Survey of Self-Care and Aging.

Using data collected from the first wave of a longitudinal data set collected in the late fall and winter of 1990-1991, the National Survey of Self-Care and Aging (NSSCA), we examined the extent and type of assistance older people provided to others. Age, gender, and perceived health status were the most consistent predictors of the four types of assistance: personal care, child care, volunteer work, and listening/offering advice and support. Help with instrumental activities of daily living either alone or in combination with other activities of daily living was the most common type of personal care provided.

Activities of Daily Living↗
PubMed1999

The effects of family conflict resolution and decision making on the provision of help for an elder with Alzheimer's disease.

This study explored how characteristics of multigeneration families of patients with Alzheimer's disease (AD) affected the family's ability to provide help to their ill elder. An intensive patient and family assessment battery was employed with 211 families with an elder with AD, and measures of the amount and kind of help offered by the family group were recorded. Above and beyond control variables, families that used a focused decision-making style and positive conflict resolution methods provided more help than families that did not use these styles and methods. These data suggest the importance of the family system of care in disease management.

Adult↗
PubMed1999

Patterns and predictors of formal and informal care among elderly persons living in board and care homes.

The purpose of this study was to investigate the patterns and predictors of formal and informal help among a sample of older persons living in board and care homes (N = 617). Formal helpers such as facility staff, service agencies, and community organizations were the most common providers of assistance, particularly for activities of daily living (ADLs; e.g., bathing, dressing, toileting) that required close and continual proximity. Informal helpers such as family members, friends, and other residents were most likely to assist with instrumental ADL (IADL) tasks such as shopping and getting around outside. The need for assistance with ADLs predicted the amount of formal ADL help received by residents, whereas both ADL need and the presence of mental illness predicted the amount of IADL help received from formal sources. In contrast, demographic factors such as gender and race, as well as the frequency of family contact, predicted the amount of informal help with IADL tasks. White residents, women, and those with frequent family contact were among those most likely to receive assistance from informal helpers. The results suggest the need to encourage the provision of informal assistance as well as the need to ensure the availability of sufficient staff and other formal helpers are available to provide formal care in these settings.

Activities of Daily Living↗
PubMed2003

Recruitment and retention of latino dementia family caregivers in intervention research: issues to face, lessons to learn.

PURPOSE: This article reviews and critiques several issues of importance to those whose goal is to make intervention research with Latino caregivers more "user-friendly." Issues range from current demographic trends showing the ever-increasing number of Latino caregivers to discussion of cultural values that influence their help-seeking behavior. DESIGN AND METHODS: This article presents a review of current published information on this topic. The gerontological literature was searched for the past decade for relevant material; in addition, the authors' own experience in this area is described. RESULTS: Although limited information was found that derived from actual empirical studies, a number of articles describe potential barriers to research involvement and provide suggestions for making participation more attractive and culturally appropriate for Latinos. IMPLICATIONS: Clinical researchers need to increase their sensitivity to such issues as cultural values and language preference and develop effective collaborations with the Latino community so that intervention research programs can be designed and implemented successfully with Latinos caring for cognitively impaired elderly family members at home.

Aged↗
PubMed2005

Caregiver supervision and child-injury risk: I. Issues in defining and measuring supervision; II. Findings and directions for future research.

OBJECTIVE: To discuss the role of caregiver supervision in child-injury risk, with attention given to definitional and methodological issues and outlining important questions to be addressed in future research. METHODS: Analysis, synthesis, and critique of existing literature. RESULTS: Comparisons across studies are difficult because of insufficient specificity regarding what constitutes supervision. Hence, a multi-dimensional definition of supervision is developed based on the literature. Numerous issues arise when attempting to measure supervision and these are extensively discussed, along with reporting on the recent development of two questionnaire measures of supervision (Beliefs About Supervision Questionnaire and Parent Supervision Attributes Profile Questionnaire) that have shown good validity and hold promise for addressing the problem of measuring caregiver supervision in reliable and valid ways. A review of the findings on relations between supervision and child-injury risk reveals that many substantive questions remain unanswered. A number of recommendations for future research are given and a conceptual model is presented that focuses attention on the need for research that examines how factors interact to influence child-injury risk. This model has relevance not only for research but also for prevention and serves to emphasize the complementary nature of environment-oriented and person-oriented approaches to child-injury prevention. CONCLUSION: Direct evidence linking supervision to child-injury risk is scarce and many important questions remain unanswered. Based on the conceptual model presented, in future research it is important to examine how supervision interacts with other key factors to influence children's risk of injury.

Caregivers↗
PubMed2006

Attributions of adolescents with type 1 diabetes related to performing diabetes care around friends and peers: the moderating role of friend support.

OBJECTIVE: To examine the relationships among negative attributions of friend and peer reactions to diabetes management in social situations, anticipated adherence difficulties, friend support, diabetes stress, and metabolic control. METHODS: A sample of 102 adolescents with Type 1 diabetes completed instruments measuring attribution of friend and peer reactions, anticipated adherence, friend support, and diabetes stress. Metabolic control was measured by the percentage of hemoglobin A1c. RESULTS: Structural equation modeling demonstrated an excellent fit of two models depicting the mediating role of anticipated adherence difficulties and diabetes stress on the relationship between negative attributions of friend (first model) and peer (second model) reactions and metabolic control. Friend support was found to moderate the path between diabetes stress and metabolic control in an unexpected manner. That is, as friend support increased, so did the relationship between stress and metabolic control. CONCLUSIONS: Adolescents who make negative attributions about reactions of friends and/or non friend peers are likely to find adherence difficult in social situations and have increased stress, with the latter associated with metabolic control. Results are discussed in terms of a social information processing model of adjustment.

Adolescent↗
PubMed1981

Prevalence of depression in Los Angeles County.

The occurrence of depression was determined during the summer of 1979 in a multi-ethnic probability sample of 1003 adults (66% participation) in Los Angeles County, as part of a community survey of the epidemiology of depression and help-seeking behavior. The primary measure of depression was the 20-item CES-D scale developed by the Center for Epidemiologic Studies. The overall prevalence of depression based on a CES-D cutpoint definition of 16 or greater was 19.1%. The prevalence of depression was greatest among Hispanics (27.4%) and least among whites (15.6%), with blacks and others at an intermediate level (21.8% and 21.2%, respectively). Females (23.5%) were nearly twice as likely to be depressed as males (12.9%). By age, persons 18-24 years reported the highest rate of depression (27.4%), while those 45-64 years reported the lowest (16.3%). As expected, the prevalence of depression was strongly related to family income, with the highest level reported for those earning less than $8500 (29.3%); the lowest level for those earning more than $25,000 (9.0%). After controlling for effects of selected demographic and socioeconomic variables, neither race nor ethnicity were significantly related to the presence of depression. This suggests that the economic strain experienced by many minorities may be an important determinant of higher rates of depression among blacks and Hispanics.

Adolescent↗
PubMed1992

Is abdominal body fat distribution a major explanation for the sex difference in the incidence of myocardial infarction? The study of men born in 1913 and the study of women, Göteborg, Sweden.

The authors considered whether the difference in body fat distribution between men and women, measured as waist:hip ratio, might explain part of the sex difference in coronary heart disease incidence in prospective population studies of 1,462 women and 792 men. In these studies, conducted in Sweden, men were found to have about four times higher odds for coronary heart disease than women during a 12-year follow-up period (men, 1967 to 1979; women, 1968-1969 to 1980-1981). Controlling for differences in blood pressure, serum cholesterol, smoking, and body mass index only marginally altered the magnitude of the male-female difference. When waist:hip ratio, which predicted coronary heart disease rates in both sexes, was also considered, the sex difference in coronary heart disease risk was significantly reduced and virtually disappeared (odds ratios = 1.0-1.1; nonsignificant). The findings suggest that body fat distribution or a factor highly correlated with waist:hip ratio (genetic, hormonal, or behavioral) may help to explain the sex differences in coronary heart disease.

Abdomen↗
PubMed1995

Schizophrenia among Hispanics: epidemiology, phenomenology, course, and outcome.

A number of studies point to the influence of culture and ethnicity on the presentation and course of schizophrenia. In general, a relatively powerful influence of environmental factors is identified. This article reviews the literature on schizophrenia among Hispanics in the United States and uses the results of this review as a basis for identifying directions for future study. Research is divided into three major areas: epidemiology, phenomenology, and illness course and outcome. Ethnic comparisons suggest similar prevalence rates of schizophrenia. However, differences in illness phenomenology between certain subgroups of Hispanics are also observed. Moreover, culture can affect various aspects of the illness process, including illness definition, help- seeking behavior, response to treatment, and post-treatment adjustment. Proposed guidelines to direct future research ventures include (1) better delineation of the sociocultural attributes of the group under study, (2) validation of assessment instruments across ethnic groups, (3) use of innovative approaches to assess incidence and prevalence, (4) incorporation of qualitative methodology, (5) use of illness behavior models to provide a conceptual framework to guide investigations, and (6) integration of cross-cultural and biological studies.

Cross-Cultural Comparison↗
PubMed1996

Earlier detection and intervention in schizophrenia: unsolved questions.

Secondary prevention in schizophrenia is still not good enough, and the authors of the articles in this issue of Schizophrenia Bulletin present important new knowledge that may increase earlier detection and treatment. This final article discusses some of their main findings in relation to clinical consequences and new research. We need more knowledge about the clinical characteristics of the prodromal phase and about the factors that influence the help-seeking behavior of patients and families in the early phases of schizophrenia. The new models presented for early detection and treatment are promising and should be replicated in other countries and on other continents.

Biomarkers↗