Influence of Socioeconomic Factors on Daily Life Activities and Quality of Life of Thai Elderly.
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ABSTRACT:
SUBMITTER: Somrongthong R
PROVIDER: S-EPMC5523003 | biostudies-other | 2017 Apr
REPOSITORIES: biostudies-other
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Project description:BackgroundTo date, few studies address disparities in older populations specifically using frailty as one of the health outcomes and examining the relative contributions of individual and environmental factors to health outcomes.Methodology/principal findingsUsing a data set from a health survey of 4,000 people aged 65 years and over living in all regions of Hong Kong, we examined regional variations in self-rated health, frailty, and four-year mortality, and analyzed the relative contributions of lifestyle, socioeconomic status, and geographical location of residence to these outcomes using path analysis. We hypothesize that lifestyle, socioeconomic status, and regional characteristics directly and indirectly through interactions contribute to self-rated physical and psychological health, frailty, and four-year mortality. District variations directly affect self-rated physical health, and also exert an effect through socioeconomic position as well as lifestyle factors. Socioeconomic position in turn directly affects self-rated physical health, as well as indirectly through lifestyle factors. A similar pattern of interaction is observed for self-rated mental health, frailty, and mortality, although there are differences in different lifestyle factors and district associations. Lifestyle factors also directly affect physical and mental components of health, frailty, and mortality. The magnitude of direct district effect is comparable to those of lifestyle and socioeconomic position.Conclusions/significanceWe conclude that district variations in health outcomes exist in the Hong Kong elderly population, and these variations result directly from district factors, and are also indirectly mediated through socioeconomic position as well as lifestyle. Provision and accessibility to health services are unlikely to play a significant role. Future studies on these district factors would be important in reducing health disparities in the older population.
| S-EPMC2808254 | biostudies-literature
Project description:This study examined whether activities of daily living (ADL) mediate the relationship between depression and health-related quality of life (HR-QOL) in people with Parkinson's disease (PD). A cross-sectional, correlational research design examined data from 174 participants who completed the Geriatric Depression Scale (GDS-15), Parkinson's Disease Questionnaire-39 (PDQ-39), and Unified Parkinson's Disease Rating Scale-section 2 (UPDRS-section 2 [ADL]). Multiple Regression Analysis (MRA) was used to examine the mediator model. Depression and ADL significantly (p<.001) predicted HR-QOL, and depression significantly (p<.001) predicted ADL. Whilst ADL did not impact on the relationship between depression and HR-QOL, there was a significant (p<.001) indirect effect of depression on HR-QOL via ADL, suggesting both direct and indirect (via ADL) effects of depression on HR-QOL. The magnitude of this effect was moderate (R2 = .13). People with PD who report depression also experience greater difficulty completing ADL, which impacts upon their HR-QOL. It is recommended that clinicians adopt a multidisciplinary approach to care by combining pharmacological treatments with psycho/occupational therapy, thereby alleviating the heterogeneous impact of motor and non-motor symptoms on HR-QOL in people with PD.
| S-EPMC4099301 | biostudies-other
Project description:Primary outcome(s): QOL assessment, self-efficacy assessment, assessment of work productivity and activity impairment, and assessment of employment activities
| 2729001 | ecrin-mdr-crc
Project description:BackgroundThis study's aim was to clarify the relationship of having hobbies and a purpose in life (PIL; in Japanese, ikigai) with mortality and a decline in the activities of daily living (ADL) and instrumental ADL (IADL) among the community-dwelling elderly.MethodsProspective observational data from residents aged ?65 years who were at increased risk for death (n = 1853) and developing a decline in ADL (n = 1254) and IADL (n = 1162) were analyzed. Cox proportional hazard models were used for mortality analysis of data from February 2011 to November 2014. ADL and IADL were evaluated using the Barthel Index and the Tokyo Metropolitan Institute of Gerontology Index of Competence, respectively. ADL and IADL were assessed at baseline and follow-up and were evaluated using logistic regression models. Fully adjusted models included terms for age, gender, BMI, income, alcohol intake, smoking history, number of chronic diseases, cognitive function, and depression.ResultsDuring the follow-up of eligible participants, 248 had died, 119 saw a decline in ADL, and 178 saw a decline in IADL. In fully adjusted models, having neither hobbies nor PIL was significantly associated with an increased risk of mortality (hazard ratio 2.08; 95% confidence interval [CI], 1.47-2.94), decline in ADL (odds ratio 2.74; 95% CI, 1.44-5.21), and decline in IADL (odds ratio 1.89; 95% CI, 1.01-3.55) compared to having both hobbies and PIL.ConclusionsAlthough effect modifications by cognitive functioning and depression cannot be ruled out, our findings suggest that having hobbies and PIL may extend not only longevity, but also healthy life expectancy among community-dwelling older adults.
| S-EPMC4919481 | biostudies-literature
Project description:ObjectivesTo examine the association between socioeconomic status (SES) and health-related quality of life (HRQOL) in a sample of elderly Chinese people in Hong Kong.Study designCross-sectional study.Setting18 elderly health centers in Hong Kong.ParticipantsThis study was based on a cohort aged 65 years or above who were enrolled in the Elderly Health Services from 1998 to 2005 in Hong Kong. Initially, 3324 individuals were randomly sampled from the baseline database. In the end, 2441 successful cases were obtained for the telephone survey. After excluding cases with missing SES or HRQOL information and the cases whose questionnaires were answered by their family members, 2347 individuals were included in the final analysis.ResultsElderly Chinese with less subjective economic hardship reported much better self-rated health (SRH) (OR 1.57-4.70, all p<0.01)< and higher Medical Outcomes Study short form (SF)12 scores (? 2.56-10.26, all p<0.01) than those with economic hardship. Male individuals in the highest education and occupation subgroup reported better HRQOL comparing with the baseline subgroup (OR for SRH 1.91-3.26, p<0.01; ? 2.63-4.96, p<0.05). Two economic indicators, income and expenditure, only showed significant positive associations with physical SF12 scores for men (? 2.91-5.42, all p<0.05). Housing tenure was associated with SRH (OR 1.34 for men and 1.27 for women, p<0.05) but not SF12 scores.ConclusionsEconomic hardship showed the strongest association with HRQOL among all SES indicators. Educational level, occupational level and economic indicators tended to associate with physical HRQOL only among elderly Chinese men. More attention should be placed on subjective SES indicators when investigating influences on HRQOL among elderly Chinese people.
| S-EPMC3586150 | biostudies-literature
Project description:BACKGROUND:Healthcare disparities related to socioeconomic factors may adversely impact disease states and treatment outcomes. Among patients with chronic rhinosinusitis (CRS), the impact of socioeconomic factors on outcomes following endoscopic sinus surgery (ESS) remains uncertain. METHODS:Adult patients with refractory CRS were prospectively enrolled into an observational, multi-institutional cohort study between March 2011 and June 2015. Socioeconomic factors analyzed included household income, insurance status, years of education completed, race, age, and ethnicity. Income was stratified according to the Thompson and Hickey model. The 22-item Sino-Nasal Outcome Test (SNOT-22) and Brief Smell Identification Test (BSIT) were completed preoperatively and postoperatively. RESULTS:A total of 392 patients met inclusion criteria. Higher age and male gender were associated with better mean preoperative SNOT-22 scores (both p < 0.02), whereas Medicare insurance status and male gender were associated with worse preoperative mean BSIT scores (both p < 0.02). Postoperatively, higher household income ($100,001+/year) and lower age were associated with a greater likelihood of improving at least 1 minimal clinically important difference (MCID) on SNOT-22 scores (OR = 2.40 and 1.03, respectively, both p < 0.05), while no factors were associated with increased odds of achieving a MCID on BSIT scores. CONCLUSIONS:Preoperative olfactory function and postoperative quality of life (QOL) improvement were associated with metrics of socioeconomic status in patients with CRS electing ESS. The odds of experiencing a clinically meaningful QOL improvement were more than twice as likely for patients with the highest household income level compared to other income tiers. Further investigation is warranted to identify barriers to postoperative improvement.
| S-EPMC6397069 | biostudies-literature
Project description:Purpose: This study aimed to determine whether there are differences in the factors affecting the quality of life (QOL) of elderly women in South Korea according to their perceived economic status. Methods: Data were extracted from the Seventh Korea National Health and Nutrition Examination Survey conducted in 2016. The participants were 879 women over the age of 65 years, who were divided into three groups: high, medium, and low based on their perceived economic status. The study variables were classified into three categories: general characteristics, physical factors, and psychological factors. General characteristics included age, education level, employment, activity restriction, frequency of breakfast/week, frequency of lunch/week, and frequency of dinner/week. Physical factors included disease status, weight change, consumption of alcohol, number of days of walking per week, duration of walking at a time, body mass index (BMI), and discomfort due to changes in hearing. Psychological factors included stress, subjective body awareness, subjective health status, depressive symptoms, and QOL. Complex sample crosstabs and chi-square tests were conducted, and regression was performed to examine the association between the variables by economic status. Results: The factors that influenced the QOL of elderly women with low economic status were arthritis, alcohol consumption, subjective health status, and depressive symptoms, with an explanatory power of 54.3% (F = 14.94, p < 0.001). The factors that influenced the QOL of the medium economic status group were activity restriction, frequency of dinner/week, arthritis, number of days of walking per week, BMI, stress, subjective health status, and depressive symptoms, with an explanatory power of 48.6% (F = 9.82, p < 0.001). For the high economic status group, influential factors were age, restricted activity, arthritis, number of days of walking per week, stress, and depressive symptoms with an explanatory power of 49.0% (F = 69.76, p < 0.001). Conclusions: This study identified different factors that contributed to the QOL of elderly women by economic status.
| S-EPMC7038010 | biostudies-literature
Project description:Objectives:This article models the chain of risk that links life course socioeconomic status (SES), daily stressor exposure and severity, and daily well-being. Method:Data from the main survey and the daily diary project of the Midlife in the United States (MIDUS) Refresher study were combined, resulting in 782 participants (55.6% female; age 25-74, Mage = 47.9) who reported on 5,849 days of information on daily stressors and daily well-being. Data were measured at both person and day levels. Between-person predictor variables include childhood SES, education, and adult SES. Within-person daily variables assessed exposure to daily stressors, severity of daily stressors, positive affect, negative affect, and daily physical symptoms. We contrasted hypothesized models, the chain of risk trigger effect model versus the additive model within a multilevel structural equation modeling framework. Results:The influences of life course SES and daily stressor exposure and severity on daily well-being were better described by the chain of risk additive model than the chain of risk trigger effect model. Childhood SES was directly and indirectly (through education, adult SES, and daily stressor exposure and severity) associated with daily well-being (in between-person level), especially daily physical symptoms and daily negative affect. Discussion:Childhood may be a sensitive period that has salient implications for day-to-day well-being later in life.
| S-EPMC6294233 | biostudies-literature
Project description:Knowledge of experiences from prostate cancer is sparse in a longitudinal perspective. From a nursing perspective, results from combined qualitative and quantitative studies are lacking however would present the broadest knowledge base for best practice. Present descriptions of medical-physical symptoms such as urinary, bowel and sexual dysfunction from quantitative inquiries need be complemented with qualitative results. Such knowledge is essential in relation to treatment and communication with patients over the years and not only shortly after surgery.A longitudinal study was formatted to investigate general and specific health quality and sense of coherence quantitative alterations over three years. A general health quality module (EORTC QLC-C30) and a disease-specific module (EORTC PR-25) were applied for the longitudinal study together with the Orientation to life questionnaire (SOC), measuring a persons' sense of coherence. In order to strengthen reliability and compensate for low participation we used the Directed content analysis for interviewing and analysis. The method allows using findings from earlier research when interviewing along with detecting new areas. Twenty-one men were followed over three years and six of them, in the third year, accepted to be interviewed.We found high quality of life ratings and extended the study with follow-up interviews in year three, to investigate whether questionnaire results were in line with interview findings. We found high life quality and functioning ratings that were in line with qualitative descriptions. Interview analysis showed retrieval of life as lived before, yet in a different way, the men never forgot the diagnosis event, had a unique illness history worth hearing, and had come to terms with most treatment-related shortcomings. Sense of coherence ratings were medium to high and confirmed stability over time in comprehensibility, manageability and meaningfulness after prostate cancer treatment.Over the years, the men's negative experiences from shifted into 'a good life' though in a different way than before. The interpretation is supported in the study by quantitative results showing a high degree of functioning. The men's sense of coherence seamed to support their handling of life three years after prostate cancer treatment.
| S-EPMC3626890 | biostudies-other
Project description:BackgroundThe proportion of older people is increasing rapidly in Vietnam. The majority of the elderly live in rural areas. Their health status is generally improving but this is less pronounced among the most vulnerable groups. The movement of young people for employment and the impact of other socioeconomic changes leave more elderly on their own and with less family support. This study aims to assess the daily care needs and their socioeconomic determinants among older people in a rural setting.MethodsIn 2007, people aged 60 years and older, living in 2,240 households, were randomly selected from the FilaBavi Demographic Surveillance System (DSS). They were interviewed using structured questionnaires to assess needed support in activities of daily living (ADLs). Individuals were interviewed about the presence of chronic illnesses that had been diagnosed by a physician. Participant socioeconomic characteristics were extracted from the FilaBavi repeat census. The repeat census used a repeat of the same survey methods and questions as the original FilaBavi DSS. Distributions of study participants by socioeconomic group, supports needed, levels of support received, types of caregivers, and the ADL index were described. Multivariate analyses were performed to identify socioeconomic determinants of the ADL index.ResultsThe majority of older people do not need of support for each specific ADL item. Dependence in instrumental or intellectual ADLs was more common than for basic ADLs. People who need total help were less common than those who need some help in most ADLs. Over three-fifths of those who need help receive enough support in all ADL dimensions. Children and grandchildren are the main caregivers. Age group, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, poverty status, and chronic illnesses were determinants of daily care needs in old age.ConclusionsAlthough majority of older people who needed help received enough support in daily care, the need of care is more demanded in disadvantaged groups. Future community-based, long-term elderly care should focus on instrumental and intellectual ADLs among the general population of older people, and on basic ADLs among those with chronic illnesses. Socioeconomic determinants of care needs should be addressed in future interventions.
| S-EPMC3239225 | biostudies-literature