Dataset Information

Population Priorities for Successful Aging: A Randomized Vignette Experiment.

ABSTRACT: OBJECTIVES:Aging populations have led to increasing interest in "successful aging" but there is no consensus as to what this entails. We aimed to understand the relative importance to the general population of six commonly-used successful aging dimensions (disease, disability, physical functioning, cognitive functioning, interpersonal engagement, and productive engagement). METHOD:Two thousand and ten British men and women were shown vignettes describing an older person with randomly determined favorable/unfavorable outcomes for each dimension and asked to score (0-10) how successfully the person was aging. RESULTS:Vignettes with favorable successful aging dimensions were given higher mean scores than those with unfavorable dimensions. The dimensions given greatest importance were cognitive function (difference [95% confidence interval {CI}] in mean scores: 1.20 [1.11, 1.30]) and disability (1.18 [1.08, 1.27]), while disease (0.73 [0.64, 0.82]) and productive engagement (0.58 [0.49, 0.66]) were given the least importance. Older respondents gave increasingly greater relative importance to physical function, cognitive function, and productive engagement. DISCUSSION:Successful aging definitions that focus on disease do not reflect the views of the population in general and older people in particular. Practitioners and policy makers should be aware of older people's priorities for aging and understand how these differ from their own.

SUBMITTER: Whitley E

PROVIDER: S-EPMC6974399 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Population Priorities for Successful Aging: A Randomized Vignette Experiment.

Whitley Elise E Benzeval Michaela M Popham Frank F

The journals of gerontology. Series B, Psychological sciences and social sciences 20200101 2

<h4>Objectives</h4>Aging populations have led to increasing interest in "successful aging" but there is no consensus as to what this entails. We aimed to understand the relative importance to the general population of six commonly-used successful aging dimensions (disease, disability, physical functioning, cognitive functioning, interpersonal engagement, and productive engagement).<h4>Method</h4>Two thousand and ten British men and women were shown vignettes describing an older person with rando ...[more]

PMID: 29878183

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Project description:Understanding and eliminating mental illness stigma is crucial for improving population mental health. In many settings, this stigma is gendered, from the perspectives of both the stigmatized and the stigmatizers. We aimed to find the differences in the level of stigma across different mental disorders while considering the gender of the study participants as well as the gender of the people depicted in the vignettes. This was a population-based, experimental vignette study conducted in Buyende District of Eastern Uganda in 2023. We created 8 vignettes describing both men and women with alcohol use disorder, major depressive disorder, generalized anxiety disorder, and schizophrenia consistent with DSM-5 criteria. Participants from 20 villages in rural Buyende District of Uganda (N=379) were first read a randomly selected vignette and administered a survey eliciting their attitudes (Personal Acceptance Scale [PAS] and Broad Acceptance Scale [BAS]) towards the person depicted in the vignette. We used analysis of variance (ANOVA) with Bonferroni-adjusted, empirical p-values to compare levels of acceptance across disorders and genders. Attitudes towards people with mental illness, as measured by the PAS, varied across different mental disorders (p=0.002). In pairwise mean comparisons, the greater acceptance of anxiety disorder vs. schizophrenia was statistically significant (Mean [SD] PAS: 2.91 [3.15] vs 1.62 [1.95], p=0.008). Secondary analyses examining differences in acceptance across gender combinations within mental disorders showed that PAS varied across gender combinations for depression (p=0.017), suggesting that acceptance is higher for women with depression than men with depression. In this population-based vignette study from rural Uganda, we found that people with schizophrenia were less accepted compared to people with anxiety disorders. We also found that there was greater acceptance of women with depression than men with depression. Anti-stigma initiatives may need to be targeted to specific disorders and genders.

Project description:BackgroundThe per diem financial structure of hospice care may lead agencies to consider patient-level factors when weighing admissions.ObjectiveTo investigate if treatment cost, disease complexity, and diagnosis are associated with hospice willingness to accept patients.DesignIn this 2019 online survey study, individuals involved in hospice admissions decisions were randomized to view one of six hypothetical patient vignettes: "high-cost, high-complexity," "low-cost, high-complexity," and "low-cost, low-complexity" within two diseases: heart failure and cystic fibrosis. Vignettes included demographics, prognoses, goals, and medications with costs. Respondents indicated their perceived likelihood of acceptance to their hospice; if likelihood was <100%, respondents were asked the barriers to acceptance. We used bivariate tests to examine associations between demographic, clinical, and organizational factors and likelihood of acceptance.ParticipantsIndividuals involved in hospice admissions decisions MAIN MEASURES: Likelihood of acceptance to hospice care KEY RESULTS: N=495 (76% female, 53% age 45-64). Likelihoods of acceptance in cystic fibrosis were 79.8% (high-cost, high-complexity), 92.4% (low-cost, high-complexity), and 91.5% (low-cost, low-complexity), and in heart failure were 65.9% (high-cost, high-complexity), 87.3% (low-cost, high-complexity), and 96.6% (low-cost, low-complexity). For both heart failure and cystic fibrosis, respondents were less likely to accept the high-cost, high-complexity patient than the low-cost, high-complexity patient (65.9% vs. 87.3%, 79.8% vs. 92.4%, both p<0.001). For heart failure, respondents were less likely to accept the low-cost, high-complexity patient than the low-cost, low-complexity patient (87.3% vs. 96.6%, p=0.004). Treatment cost was the most common barrier for 5 of 6 vignettes.ConclusionsThis study suggests that patients receiving expensive and/or complex treatments for palliation may have difficulty accessing hospice.

Dataset Information

Population Priorities for Successful Aging: A Randomized Vignette Experiment.

Publications

Population Priorities for Successful Aging: A Randomized Vignette Experiment.

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