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Validity and reliability of the Positive Aspects of Caregiving (PAC) scale and development of its shorter version (S-PAC) among family caregivers of older adults
To (a) assess the validity and reliability of the 9-item Positive Aspects of Caregiving (PAC) scale among a national sample of caregivers for older adults with functional limitations, (b) develop a shorter version (short-PAC [S-PAC] scale) and assess its psychometric properties, and (c) investigate both scales’ measurement equivalence/invariance (ME/I) across language of administration (Chinese/English/Malay).
For the 9-item PAC scale, the “original” 2-factor CFA model had a poor fit; its EFA and scale/item measurement properties supported a single factor. Among alternate CFA models, a bi-factor model (all nine items: first factor [overall PAC]; six items: second factor [self-affirmation]; three items: third factor [outlook-on-life]) had the best fit. The bi-factor CFA model also had a good fit for the S-PAC scale, developed after eliminating 2 items from the 9-item PAC scale. Both scales demonstrated convergent and divergent validity, and partial ME/I across language of administration.
Both the 9-item PAC and 7-item S-PAC scales can be used to assess positive feelings resulting from care provision among family caregivers of older adults with functional limitations.Visit
The role of a multicomponent home-health intervention in reducing caregiver stress in Singapore: A qualitative study
The relationship between caregiving and negative health outcomes is well established in the literature. Previous studies have shown that community-based programs reduce caregiver stress. However, the mechanisms by which this happens have not been well investigated. This qualitative study examines caregivers’ experiences as a part of the Aging-In-Place intervention, a home-health program in Singapore targeted at frequently hospitalized patients and their caregivers.
We interviewed 32 caregivers to study the underlying processes by which caregiver stress was ameliorated. Transcripts from semistructured interviews were analyzed thematically within the theoretical framework of the stress process model.
Primary stressors related to routine patient care were reduced through the intervention program that provided health monitoring to patients and facilitated linkages to community-based services. Increased access to advice and medical information provided by intervention staff reduced caregivers’ uncertainty, a substantial secondary stressor. Caregivers who employed a foreign domestic worker (FDW) gained additional reductions in both primary and secondary stressors.
The multidimensional home-health intervention reduced both primary and secondary stressors for caregivers. FDWs constituted a resource that caregivers could rely on and the training provided to FDWs by intervention staff further reduced caregiver stress. Implications for program planning and future research are discussed.Visit
Dental health status of community-dwelling older Singaporeans: Findings from a nationally representative survey
To assess the dental health status of older Singaporeans by age, gender and ethnicity. Poor dental health in elders has been linked to a number of adverse health conditions and is often associated with an increased risk of mortality in older people.
Data came from a nationally representative cross-sectional 2009 survey of community-dwelling Singaporeans aged 60 and over. The distribution of the number of natural teeth, chewing ability and the presence of dentures were assessed by age, gender and ethnicity (Chinese/Malay/Indian) using sampling weights.
With increasing age, there was a decrease in the average number of natural teeth, a decrease in the proportion of people with 20 or more natural teeth and with the strongest chewing ability, and an increase in the proportion that was edentulous or had dentures. Women, vs. men, had a lower average number of natural teeth (10.3 vs. 12.8), and they were more likely to be edentulous (37 vs. 24%) and to have dentures (73 vs. 63%). Across ethnic groups, Indians had the highest average number of natural teeth (17.0). However, among those who had dentures, Indians were the least likely to have the strongest chewing ability.
The findings demonstrated differences in dental health status by age, gender and ethnicity. They highlight the need for improvements in the dental health status of all older Singaporeans, especially older women. The data presented herein may serve as a baseline for policymakers to evaluate the impact of recent schemes launched by the Ministry of Health (Singapore) to subsidise dental treatment.Visit
Older nurses in Singapore: Factors associated with attitudes towards extending working life
We aim to determine associations between demographic variables, motivation to work, economic factors, work demands and organisational attitudes towards older workers and whether nurses want to extend working life. Singapore’s ageing workforce, coupled with the government’s enactment of re-employment legislation, calls for attention on older nurses’ concerns and views about working longer.
A cross-sectional survey with nurses aged 50 and above was conducted. Data from 355 respondents was analysed. Malay nurses were significantly less likely (OR 0.3, 95%CI 0.1–0.6) than Chinese nurses to want to work longer. Financing one’s retirement, societal trends in postponing retirement and physical capability to continue working were factors significantly associated with older nurses’ decisions to extend working life. Approximately 40% of older nurses in Singapore want to work up to and above age 65. Race, societal attitudes and economic factors contribute in older nurses’ decisions on retirement.
Given an ageing workforce and manpower shortage, it is important for nurse managers and higher authorities to devise strategies to keep nurses in the workforce as long as possible. This study highlights concerns and attitudes of older nurses towards extending working life, and could inform future planning of strategies to retain older nurses.
Fifteen Dimensions of Health and their Associations with Quality of Life among Elderly in Rural Villages in Maharashtra, (India)
Elderly health is a growing priority given growing older-adult populations worldwide. The present study aimed to identify factors that influence health and quality of life (QoL) specifically in rural-dwelling elderly Indians. A cross-sectional survey of 352 elders (=60y) from 10 villages near Pune, Maharashtra, India was conducted to measure the prevalence of 15 dimensions of health: vision, hearing, cognition, mental, social (generativity), physical activity, substance-use, physical-strength, independence in activities of daily living (ADL) and instrumental ADL (IADL), dental, nutrition, chronic-pain, sleep and safety (falls).
The researchers then examined the associations between these health dimensions and QoL using linear regression. It was found that in general, these elders were physically active (70%), independent and cognitively-intact (55%), however only a minority were free from problems relating to vision (33%), dental (45%), nutrition (30%), mental health (34%) and chronic pain (40%). Adjusted analysis revealed that higher QoL scores were associated with healthy status in seven dimensions: vision (β=4.9, p<0.001), hearing (β=3.5, p=0.003), sleep (β=4.1, p<0.001), dental (β=2.6, p=0.017), mental (β=2.1, p=0.048), independence in ADL (β=4.6, p=0.016) and social health (β=0.3, p<0.001). On the basis of these findings it may be concluded that to achieve comprehensive health and QoL in Elderlies, a proactive and diverse approach to optimizing all significant dimensions of health should be adopted. This is particularly important in rural areas where available medical resources may be limited when it comes to addressing elderly health decline.Visit
Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19·1 million participants
Raised blood pressure is an important risk factor for cardiovascular diseases and chronic kidney disease. We estimated worldwide trends in mean systolic and mean diastolic blood pressure, and the prevalence of, and number of people with, raised blood pressure, defined as systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher.
During the past four decades, the highest worldwide blood pressure levels have shifted from high-income countries to low-income countries in south Asia and sub-Saharan Africa due to opposite trends, while blood pressure has been persistently high in central and eastern Europe.Visit
Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India
In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India.
Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable.
This study is among the few to assess caregiver burden among family caregivers of older persons with impairments residing in a rural community in India. Caregivers caring for an older person with (versus without) physical impairment had significantly higher caregiver burden score. Caregivers caring for an older person with all four impairments (versus only one) had significantly higher caregiver burden score. Health and social care professionals must recognize and reach out to such vulnerable family caregivers.Visit
Normative Values of Hand Grip Strength for Elderly Singaporeans Aged 60 to 89 Years: A Cross-Sectional Study
What are normative values for hand grip strength (HGS) for elderly Singaporeans? Which elderly characteristics influence the normative values of HGS for elderly Singaporeans?
This study uses a large, nationally representative sample to establish normative values for HGS for elderly Singaporeans aged 60 to 89 years. These results will facilitate the interpretation of HGS measurements conducted using Smedley spring-type dynamometers in clinical and research settings in Singapore, and potentially other Asian countries.Visit
Variation in the Gender Gap in Inactive and Active Life Expectancy by the Definition of Inactivity Among Older Adults
To assess variation in gender gap (female–male) in inactive life expectancy (IALE) and active life expectancy (ALE) by definition of inactivity. Inactivity, among older Singaporeans, was defined as follows: Scenario 1—health-related difficulty in activities of daily living (ADLs); Scenario 2—health-related difficulty in ADLs/instrumental ADLs (IADLs); Scenario 3—health-related difficulty in ADLs/IADLs or non-health-related non-performance of IADLs.
Multistate life tables computed IALE and ALE at age 60, testing three hypotheses: In all scenarios, life expectancy, absolute and relative IALE, and absolute ALE are higher for females (Hypothesis 1 [H1]); gender gap in absolute and relative IALE expands, and in absolute ALE, it contracts in Scenario 2 versus 1 (Hypothesis 2 [H2]); gender gap in absolute and relative IALE decreases, and in absolute ALE, it increases in Scenario 3 versus 2 (Hypothesis 3 [H3]).
H1 was supported in Scenarios 1 and 3 but not Scenario 2. Both H2 and H3 were supported. Definition of inactivity influences gender gap in IALE and ALE.Visit
A century of trends in adult human height
Being taller is associated with enhanced longevity, and higher education and earnings. We reanalysed 1472 population-based studies, with measurement of height on more than 18.6 million participants to estimate mean height for people born between 1896 and 1996 in 200 countries. The largest gain in adult height over the past century has occurred in South Korean women and Iranian men, who became 20.2 cm (95% credible interval 17.5–22.7) and 16.5 cm (13.3–19.7) taller, respectively. In contrast, there was little change in adult height in some sub-Saharan African countries and in South Asia over the century of analysis. The tallest people over these 100 years are men born in the Netherlands in the last quarter of 20th century, whose average heights surpassed 182.5 cm, and the shortest were women born in Guatemala in 1896 (140.3 cm; 135.8–144.8). The height differential between the tallest and shortest populations was 19-20 cm a century ago, and has remained the same for women and increased for men a century later despite substantial changes in the ranking of countries.Visit