International Journal of Environmental Research and Public Health

Editorial

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3 pages, 247 KiB

Open AccessEditorial

Defining and Implementing Value-Based Healthcare for Older People from a Geriatric and Gerontological Perspective

by Yoshihisa Hirakawa

Int. J. Environ. Res. Public Health 2022, 19(18), 11458; https://doi.org/10.3390/ijerph191811458 - 12 Sep 2022

Cited by 1 | Viewed by 1511

Abstract

The world’s population is ageing at a faster rate than ever before; it is estimated that there are currently over 1 billion people aged 60 years or older, mostly living in low- and middle-income countries [...] Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

Research

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17 pages, 589 KiB

Open AccessArticle

Delivering Integrated Community Care for the Elderly: A Qualitative Case Study in Southern China

by Yiqiao Li, Lan Luo and Hongying Dong

Int. J. Environ. Res. Public Health 2024, 21(6), 680; https://doi.org/10.3390/ijerph21060680 - 25 May 2024

Viewed by 1375

Abstract

The rapid aging and increasing care demands among the elderly population present challenges to China’s health and social care system. The concept of aging in place has prompted the implementation of integrated community care (ICC) in the country. This study aims to provide [...] Read more.

The rapid aging and increasing care demands among the elderly population present challenges to China’s health and social care system. The concept of aging in place has prompted the implementation of integrated community care (ICC) in the country. This study aims to provide empirical insights into the practices of integrated care policies and approaches at the community level. Data for this study were collected through six months of participatory observations at a local community health service center in a southern Chinese city. Semi-structured interviews were conducted with the multidisciplinary community care team to gather frontline formal caregiver perceptions of ICC, thereby facilitating a better understanding of the obstacles and opportunities. Qualitative analysis revealed four themes: the ICC delivery model and development strategies within the community care scheme, the person-centered guiding principle, and the challenges and struggles encountered by formal caregivers within China’s current ICC system. The case study presented herein serves as a notable example of the pivotal role of primary care in the successful implementation of elderly care within a community setting. The adoption of a private organization-led approach to medico-social integration care in the community holds significant potential as a service delivery model for effectively addressing a wide range of elderly care issues. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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21 pages, 897 KiB

Open AccessArticle

Optimizing Older Adult Mental Health in Support of Healthy Ageing: A Pluralistic Framework to Inform Transformative Change across Community and Healthcare Domains

by Salinda Horgan, Jeanette Prorok, Katie Ellis, Laura Mullaly, Keri-Leigh Cassidy, Dallas Seitz and Claire Checkland

Int. J. Environ. Res. Public Health 2024, 21(6), 664; https://doi.org/10.3390/ijerph21060664 - 23 May 2024

Cited by 3 | Viewed by 2457

Abstract

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that [...] Read more.

This paper describes a pluralistic framework to inform transformative change across community and healthcare domains to optimize the mental health of older adults in support of healthy ageing. An extensive review and analysis of the literature informed the creation of a framework that contextualizes the priority areas of the WHO Decade of Health Ageing (ageism, age-friendly environments, long-term care, and integrated care) with respect to older adult mental health. The framework additionally identifies barriers, facilitators, and strategies for action at macro (social/system), meso (services/supports), and micro (older adults) levels of influence. This conceptual (analytical) framework is intended as a tool to inform planning and decision-making across policy, practice, education and training, research, and knowledge mobilization arenas. The framework described in this paper can be used by countries around the globe to build evidence, set priorities, and scale up promising practices (both nationally and sub-nationally) to optimize the mental health and healthy ageing trajectories of older adults as a population. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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15 pages, 813 KiB

Open AccessArticle

Attitudes towards Technology: Insights on Rarely Discussed Influences on Older Adults’ Willingness to Adopt Active Assisted Living (AAL)

by Ulrike Bechtold, Natalie Stauder and Martin Fieder

Int. J. Environ. Res. Public Health 2024, 21(5), 628; https://doi.org/10.3390/ijerph21050628 - 15 May 2024

Viewed by 1084

Abstract

Background: European research policy promotes active assisted living (AAL) to alleviate costs and reach new markets. The main argument for massive investments in AAL is its potential to raise older adults’ Quality of Life and enhance their freedom, autonomy, mobility, social integration, and [...] Read more.

Background: European research policy promotes active assisted living (AAL) to alleviate costs and reach new markets. The main argument for massive investments in AAL is its potential to raise older adults’ Quality of Life and enhance their freedom, autonomy, mobility, social integration, and communication. However, AAL is less widely spread in older adults’ households than expected. Research Aim: We investigate how the variable “technology acceptance” is connected to socio-economic-, social, health, “personal attitude towards ageing”, and “Quality of life” variables. Method: We conducted a study in Vienna between 2018 and 2020, questioning 245 older adults (M = 74, SD = 6.654) living in private homes. We calculated multivariate models regressing technology acceptance on the various exploratory and confounding variables. Results: Experiencing an event that made the person perceive their age differently changed the attitude towards using an assistive technological system. Participants perceived technology that is directly associated with another human being (e.g., the use of technology to communicate with a physician) more positively. Conclusion: Older adults’ attitudes towards technology may change throughout their lives. Using major events in life as potential entry points for technology requires awareness to avoid reducing the lives of older adults to these events. Secondly, a certain human preference for “human technology” may facilitate abuse if technology is given a white coat, two eyes, a nose, and a mouth that may falsely be associated with a natural person. This aspect raises the ethical issue of accurate information as a significant precondition for informed consent. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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14 pages, 621 KiB

Open AccessArticle

Home Care for the Elderly: An Integrated Approach to Perception, Quality of Life, and Cognition

by Luis Eduardo Genaro, José Victor Marconato, Elaine Pereira da Silva Tagliaferro, Felipe Eduardo Pinotti, Aylton Valsecki Júnior, Tânia Adas Saliba and Fernanda Lopez Rosell

Int. J. Environ. Res. Public Health 2024, 21(5), 539; https://doi.org/10.3390/ijerph21050539 - 25 Apr 2024

Cited by 4 | Viewed by 1857

Abstract

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. [...] Read more.

This study investigated the impact of home care, health status, and cognition. A qualitative and quantitative approach was employed through a cross-sectional study with a sample of 60 elderly individuals in need of home care in the municipality of Itatiba, São Paulo, Brazil. The analysis utilized the Discourse of the Collective Subject (DCS), EQ-5D, EQ VAS, and Mini-Mental State Examination (MMSE). The sample consisted of 40.0% male and 60.0% female individuals. The majority (61.6%) received weekly visits, mainly from community health agents, who were responsible for the majority of the care (45%). Positive considerations were highlighted, with 36.6% emphasizing the contribution to treatment continuity. The EQ VAS assessment indicated a moderately good perception of health. The EQ-5D analysis revealed significant differences between genders in personal care (p = 0.04). There were significant differences between clinical characteristics and EQ-5D dimensions, such as neoplasia and reduced mobility (p = 0.04), and arthritis/osteoarthritis/rheumatism and a limitation in common activities (p = 0.01). The presence of anxiety/depression was significant in cases of neoplasia (p = 0.006), arthritis/osteoarthritis/rheumatism (p = 0.01), and stroke (p = 0.04). The logistic regression analysis showed associations between usual activities and arthritis, osteoarthritis, rheumatism (p = 0.034), pain/malaise and arthritis, osteoarthritis, rheumatism (p = 0.038), and anxiety/depression and stroke (p= 0.028). The average MMSE scores (17.52) suggested a mild cognitive impairment, with no statistical differences between genders. Based on these results, it can be concluded that home care can provide a comprehensive approach and continuous assistance, emphasizing the importance of personalized care based on perceived and clinical differences. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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9 pages, 347 KiB

Open AccessCommunication

Managing Non-Cancer Chronic Pain in Frail Older Adults: A Pilot Study Based on a Multidisciplinary Approach

by Teodora Figueiredo, Luís Midão, Rute Sampaio, Joana Carrilho, Constantino Coelho, Giovanni Cerullo, Antonella Di Paola, Angelo Carfì, Graziano Onder and Elísio Costa

Int. J. Environ. Res. Public Health 2023, 20(24), 7150; https://doi.org/10.3390/ijerph20247150 - 6 Dec 2023

Viewed by 2115

Abstract

Considering the multidimensionality of chronic pain, it is crucial to develop comprehensive strategies for its effective management. However, establishing well-defined, evidence-based guidelines for such approaches remains challenging. To overcome this, we present the finding from a 4-month intervention to enhance the management of [...] Read more.

Considering the multidimensionality of chronic pain, it is crucial to develop comprehensive strategies for its effective management. However, establishing well-defined, evidence-based guidelines for such approaches remains challenging. To overcome this, we present the finding from a 4-month intervention to enhance the management of non-cancer chronic pain in older adults with pre-frailty and frailty. The intervention’s core elements comprised a multidisciplinary individualized plan, a case manager, and patient education. This pilot study involved 22 participants (≥65 years). It assessed changes in pain frequency and intensity (pain scale), frailty (Fried frailty phenotype criteria), and medication adherence (Brief Adherence Rating Scale) before and after the 4-month intervention. The results were encouraging: pain frequency and intensity and frailty score tended to decrease, and medication adherence showed significant improvement. This preliminary small-scale pilot study provides a foundation for further research and for exploring the potential scalability of this multidisciplinary patient-centred intervention. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

15 pages, 548 KiB

Open AccessArticle

Development of a Daily Living Self-Efficacy Scale for Older Adults in Japan

by Mizue Suzuki, Masahiro Shigeta, Takuya Kanamori, Marika Yokomichi, Masayo Uchiyama, Keigo Inagaki, Tomoyoshi Naito, Hajime Ooshiro and Yatami Asai

Int. J. Environ. Res. Public Health 2023, 20(4), 3292; https://doi.org/10.3390/ijerph20043292 - 13 Feb 2023

Cited by 1 | Viewed by 2078

Abstract

Objectives: Older adults tend to experience decreased enjoyment and fulfillment in life, social interactions, and independent living, with aging. These situations often result in lower levels of daily living self-efficacy in activities, which is one of the factors resulting in a decline in [...] Read more.

Objectives: Older adults tend to experience decreased enjoyment and fulfillment in life, social interactions, and independent living, with aging. These situations often result in lower levels of daily living self-efficacy in activities, which is one of the factors resulting in a decline in the quality of life (QOL) among older individuals. For this reason, interventions that help maintain daily living self-efficacy among older adults may also help maintain a good QOL. The objective of this study was to develop a daily living self-efficacy scale for the elderly that can be used to evaluate the effects of interventions aimed at enhancing self-efficacy. Methods: An expert meeting involving specialists in dementia treatment and care was held, to prepare a draft for a daily living self-efficacy scale. In the meeting, previous studies on self-efficacy among older adults, which were collected in advance, were reviewed, and the experiences of the specialists were discussed. Based on the reviews and discussions, a draft of a daily living self-efficacy scale comprising 35 items was prepared. This study on daily living self-efficacy was conducted from January 2021 to October 2021. The internal consistency and concept validity of the scale were evaluated based on the assessment data. Results: The mean age ± standard deviation of the 109 participants was 84.2 ± 7.3 years. The following five factors were extracted based on factor analysis: Factor 1, “Having peace of mind”; Factor 2, “Maintaining healthy routines and social roles”; Factor 3, “Taking personal care of oneself”; Factor 4, “Rising to the challenge”; and Factor 5, “Valuing enjoyment and relationships with others”. The Cronbach’s alpha coefficient exceeded 0.7, thereby suggesting sufficiently high internal consistency. Covariance structure analysis confirmed sufficiently high concept validity. Conclusions: The scale developed in this study was confirmed to be sufficiently reliable and valid, and when used during dementia treatment and care to assess the levels of daily living self-efficacy among older adults, it is expected to contribute to the improvement of QOL among older adults. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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9 pages, 329 KiB

Open AccessArticle

Perceptions of General Attitudes towards Older Adults in Society: Is There a Link between Perceived Life Satisfaction, Self-Compassion, and Health-Related Quality of Life?

by Anna Sofia Bratt and Cecilia Fagerström

Int. J. Environ. Res. Public Health 2023, 20(4), 3011; https://doi.org/10.3390/ijerph20043011 - 9 Feb 2023

Cited by 2 | Viewed by 2505

Abstract

Negative attitudes towards aging are common in society. However, few studies have investigated how older adults perceive this phenomenon. This study investigated (a) how older adults in Sweden perceive general attitudes towards the older population and whether negative perceptions are associated with low [...] Read more.

Negative attitudes towards aging are common in society. However, few studies have investigated how older adults perceive this phenomenon. This study investigated (a) how older adults in Sweden perceive general attitudes towards the older population and whether negative perceptions are associated with low life satisfaction, self-compassion, and health-related quality of life (HRQL), and (b) whether perceived attitudes predict life satisfaction when controlling for HRQL, self-compassion, and age. The sample comprised 698 randomly selected participants, aged 66–102 years, from the Blekinge part of the Swedish National Study on Ageing and Care. The results showed that 25.7% of the participants held negative attitudes towards older adults and reported lower life satisfaction and HRQL. Self-compassion was related to higher life satisfaction, perceived positive attitudes, and better mental HRQL. Overall, perceived attitudes, HRQL, self-compassion, and age predicted 44% of the participants’ life satisfaction. Understanding the factors that influence older adults’ life satisfaction is crucial, as health-related losses might reduce the opportunity for a successful life. Our study makes an important contribution to the field, showing that perceived attitudes explained 1.2% of the variance of life satisfaction, whereas mental and physical HRQL accounted for 18% of life satisfaction. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

14 pages, 521 KiB

Open AccessArticle

Healthcare Costs and Health Status: Insights from the SHARE Survey

by Małgorzata Cygańska, Magdalena Kludacz-Alessandri and Chris Pyke

Int. J. Environ. Res. Public Health 2023, 20(2), 1418; https://doi.org/10.3390/ijerph20021418 - 12 Jan 2023

Cited by 5 | Viewed by 2188

Abstract

The substantial rise in hospital costs over recent years is associated with the rapid increase in the older age population. This study addresses an empirical gap in the literature concerning the determinants of high hospital costs in a group of older patients in [...] Read more.

The substantial rise in hospital costs over recent years is associated with the rapid increase in the older age population. This study addresses an empirical gap in the literature concerning the determinants of high hospital costs in a group of older patients in Europe. The objective of the study is to examine the association of patient health status with in-hospital costs among older people across European countries. We used the data from the Survey of Health, Ageing and Retirement in Europe (SHARE) database. The analysis included 9671 patients from 18 European countries. We considered socio-demographic, lifestyle and clinical variables as possible factors influencing in-hospital costs. Univariate and multivariable logistic regression analyses were used to determine the determinants of in-hospital costs. To benchmark the hospital costs across European countries, we used the cost-outlier methodology. Rates of hospital cost outliers among older people varies from 5.80 to 12.65% across Europe. Factors associated with extremely high in-patient costs differ among European countries. In most countries, they include the length of stay in the hospital, comorbidities, functional mobility and physical activity. The treatment of older people reporting heart attack, diabetes, chronic lung disease and cancer are more often connected with cost outliers. The risk of being a cost outlier increased by 20% with each day spent in the hospital. We advocate that including patient characteristics in the reimbursement system could provide a relatively simple strategy for reducing hospitals’ financial risk connected with exceptionally costly cases. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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15 pages, 968 KiB

Open AccessArticle

Can the Policy of Increasing Retirement Age Raise Pension Revenue in China—A Case Study of Anhui Province

by Jin Hu, Peter-Josef Stauvermann, Surya Nepal and Yuanhua Zhou

Int. J. Environ. Res. Public Health 2023, 20(2), 1096; https://doi.org/10.3390/ijerph20021096 - 8 Jan 2023

Cited by 9 | Viewed by 2830

Abstract

With gradual progress in the medical field and the rising living standard of people, the life expectancy of people is gradually increasing. Unfortunately, this positive development contributes significantly to the aging of societies and creates huge challenges for pension systems. In order to [...] Read more.

With gradual progress in the medical field and the rising living standard of people, the life expectancy of people is gradually increasing. Unfortunately, this positive development contributes significantly to the aging of societies and creates huge challenges for pension systems. In order to mitigate the pressure on its pension system in the coming years, China is considering increasing the retirement age, just like many other countries. Based on the wage data of urban employees, pension revenue and expenditure data of employees in Anhui Province over the years, we constructed a model to predict average wages and forecast the revenue of the urban pension system from 2022 to 2032. We predicted the pension revenues by simulating an adjusted retirement age under two different schemes. The results of the study showed that the policies of appropriately increasing the retirement age can raise pension revenue. Compared with a one-step retirement age change scheme, a rolling retirement age change scheme that increases the retirement age by several months each year was found to be more suitable for the healthy development of the pension system. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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21 pages, 888 KiB

Open AccessArticle

Latent Profile Analysis of Self-Supporting Ability among Rural Empty-Nesters in Northwestern China

by Lanzhi Wei, Jianou Xu, Caifeng Luo, Rongzhu Lu and Hui Shi

Int. J. Environ. Res. Public Health 2023, 20(1), 711; https://doi.org/10.3390/ijerph20010711 - 30 Dec 2022

Viewed by 1917

Abstract

The present study aimed to examine the multi-faceted self-supporting ability profiles of rural empty-nesters in northwestern China on the basis of the self-care ability, economic self-support ability, health self-maintenance ability, physical health self-maintenance ability, and psychological health self-maintenance ability using latent profile analysis. [...] Read more.

The present study aimed to examine the multi-faceted self-supporting ability profiles of rural empty-nesters in northwestern China on the basis of the self-care ability, economic self-support ability, health self-maintenance ability, physical health self-maintenance ability, and psychological health self-maintenance ability using latent profile analysis. It identified the association of self-supporting ability profiles with demographic variables and sense of coherence. The analysis included 1066 participants (mean age = 70.2; SD = 4.3). The results of latent profile analysis identified three distinctive patterns of self-supporting ability―low physical health self-maintenance ability (C₁, 20.5%), low psychological health self-maintenance ability (C₂, 31.4%), and high social self-adaption ability (C₃, 48.0%). The specific demographic variable age (p < 0.05), monthly income (p < 0.05), education level (p < 0.05), how often their children visit (p < 0.05), how often their children contact them (p < 0.05), whether they drink (p < 0.05), the frequency of physical exercise (p < 0.05), relationship with children (p < 0.05), relationship with neighbours (p < 0.05), medical insurance (p < 0.05), and the number of chronic diseases (p < 0.05) were significantly different among the identified three profiles. A statistically significant positive association existed between self-supporting ability profiles and sense of coherence (SOC) (p < 0.001). The results of multinomial logistic regression showed that a greater sense of coherence (SOC), age ≥ 80, monthly income (RMB) (RMB is the abbreviation for Renminbi) < 1000, a good relationship with neighbours, and one type of chronic disease were significantly associated with C₁ when compared with C₃ (p < 0.05). Furthermore, a greater SOC, their children visiting and contacting them many times per week or once per week were more significantly related to C₂ than to C₃ (p < 0.05). This study revealed three groups of self-supporting ability and its related predictors in empty-nesters. The predictors related to particular classes of self-supporting ability can provide information for targeted interventions to improve the self-supporting ability of empty-nesters living in rural areas. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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10 pages, 654 KiB

Open AccessArticle

Care Staff’s Daily Living Decision-Making Support Scale for Older Adults with Dementia in Japan: Development of Validity and Reliability

by Mizue Suzuki, Takuya Kanamori, Yukio Koide, Yatami Asai, Masako Sato, Tomoyoshi Naito, Keigo Inagaki and Masao Kanamori

Int. J. Environ. Res. Public Health 2022, 19(20), 13664; https://doi.org/10.3390/ijerph192013664 - 21 Oct 2022

Cited by 1 | Viewed by 1638

Abstract

This study aimed to develop and validate a scale to assess the daily-living decision-making support of care staff for older adults with dementia (OwDs) in Japan. A questionnaire survey was conducted among 138 care staff at two geriatric healthcare facilities from February to [...] Read more.

This study aimed to develop and validate a scale to assess the daily-living decision-making support of care staff for older adults with dementia (OwDs) in Japan. A questionnaire survey was conducted among 138 care staff at two geriatric healthcare facilities from February to March 2021. The Daily Living Decision-Making Support Scale for Older Adults with Dementia (DL-DM) was developed using item analysis, factor analysis, and covariance structure analysis. The factor analysis yielded 12 items and three factors: (1) support for the formation and expression of intentions in daily life based on the life background and values of OwDs; (2) attitudes and devising ways to communicate regarding the formation and expression of intentions in OwDs daily lives; and (3) devising ways to support OwDs in realizing their intentions in daily life. The internal consistency reliability analysis yielded a Cronbach’s α of 0.87 for the total scale. The DL-DM correlated with the concurrent validity measures as expected. The DL-DM demonstrated validity and reliability as a potential scale to assess support for OwDs in daily life decision-making. The results also suggest an association between the DL-DM and person-centered care for OwDs. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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14 pages, 927 KiB

Open AccessArticle

The Mediating Effect of Self-Efficacy and Coping Strategy in Relation to Job Stress and Psychological Well-Being of Home-Visiting Care Workers for Elderly during the COVID-19 Pandemic

by Hee-Kyung Kim, Jeong-Hyo Seo and Cheol-Hee Park

Int. J. Environ. Res. Public Health 2022, 19(19), 12164; https://doi.org/10.3390/ijerph191912164 - 26 Sep 2022

Cited by 4 | Viewed by 2113

Abstract

The purpose of this study was to analyze the mediating effect of self-efficacy and coping strategy in the relationship between job stress and the psychological well-being of care workers. The subjects were 112 home-visiting care workers, and data were collected at four home-visiting [...] Read more.

The purpose of this study was to analyze the mediating effect of self-efficacy and coping strategy in the relationship between job stress and the psychological well-being of care workers. The subjects were 112 home-visiting care workers, and data were collected at four home-visiting nursing centers in a metropolitan city and a small and medium-sized city from July to August 2022. The collected data were analyzed by descriptive statistics, t-test, ANOVA, Pearson’s correlation co-efficient, multiple linear regression, and Sobel test. The mean score of psychological well-being was 3.33 ± 0.46 out of a possible 5. The subject’s psychological well-being was correlated with self-efficacy (r = 0.64, p < 0.001), problem-solving-focused coping (r = 0.58, p < 0.001), social-support-seeking coping (r = 0.34, p < 0.001), job stress (r = −0.31, p = 0.001), avoidance-focused coping (r = −0.37, p < 0.001). Self-efficacy (Z = −4.92, p < 0.001), problem-solving-focused coping (Z = −2.56, p = 0.010), and avoidance-focused coping (Z = −3.07, p = 0.002) had a mediating effect in the relationship between job stress and psychological well-being of the subjects during the COVID-19 pandemic. Based on these results, the psychological well-being nursing intervention program for home-visiting care workers need to include job stress, problem-solving-focused coping, and avoidance-focused coping. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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18 pages, 434 KiB

Open AccessArticle

Comparison between the Chief Care Manager and the Normal Care Manager on Hospitalization and Discharge Coordination Activities in Japan: An Online Cross-Sectional Study of Care Managers in Aichi Prefecture

by Yuko Goto, Hisayuki Miura and Naomi Ito

Int. J. Environ. Res. Public Health 2022, 19(19), 12122; https://doi.org/10.3390/ijerph191912122 - 25 Sep 2022

Cited by 2 | Viewed by 1705

Abstract

The Japanese long-term care insurance system came into operation in the year 2000 and the chief care manager certification system was established in 2006 to improve the quality of care management. Certified chief care managers are expected to perform the role of a [...] Read more.

The Japanese long-term care insurance system came into operation in the year 2000 and the chief care manager certification system was established in 2006 to improve the quality of care management. Certified chief care managers are expected to perform the role of a specialist. The purpose of this study was to determine the impact of the chief care manager certificate in coordination with hospitals. In this online cross-sectional survey, responses were obtained from 448 care managers engaged in long-term care activities with all in-home long-term care support providers. Among these 448 care managers, 301 had the chief care manager certificate. Of these care managers, ≥90% regularly asked their patients about their “values” and ≥80% provided their patients with hospitalization and discharge support. Of the care managers who provided their patients with hospitalization support, 80% provided the hospitals with information regarding patient “values” at the time of hospitalization, and 50% provided the hospitals with information regarding patient “values” and information. The chief care manager certificate had positive effects on confidence in hospitalization and discharge support. However, no significant difference was observed between the activities of chief and normal care managers in terms of hospitalization and discharge support. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

9 pages, 1053 KiB

Open AccessArticle

Using the Soft Systems Methodology to Link Healthcare and Long-Term Care Delivery Systems: A Case Study of Community Policy Coordinator Activities in Japan

by Yuko Goto and Hisayuki Miura

Int. J. Environ. Res. Public Health 2022, 19(14), 8462; https://doi.org/10.3390/ijerph19148462 - 11 Jul 2022

Cited by 4 | Viewed by 2496

Abstract

Due to the rapidly aging population in Japan, the government has been attempting to link the healthcare delivery system with the long-term care delivery system. However, there are complex challenges that must be overcome to link the two systems. A new methodology should [...] Read more.

Due to the rapidly aging population in Japan, the government has been attempting to link the healthcare delivery system with the long-term care delivery system. However, there are complex challenges that must be overcome to link the two systems. A new methodology should be used to organize complex community challenges and propose solutions. This study aimed to visualize the unique challenges and worldviews of interested parties in each community, using the soft systems methodology (SSM). We aimed to visualize issues and clarify challenges associated with linking the healthcare and long-term care delivery systems; in turn, clarifying the thought process behind solution proposals. We gathered information regarding those who are actively linking these systems in communities in a Japanese municipality (community care coordinators) and organized the information according to the SSM procedure. By organizing information using the SSM, we were able to summarize the present situations of the community healthcare and long-term care delivery systems, visualize issues, clarify challenges associated with linking these two systems, and propose solutions. The SSM may be useful in organizing complex community information and deriving solutions. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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14 pages, 474 KiB

Open AccessArticle

Effects of Health Status, Depression, Gerotranscendence, Self-Efficacy, and Social Support on Healthy Aging in the Older Adults with Chronic Diseases

by Hee-Kyung Kim and Jeong-Hyo Seo

Int. J. Environ. Res. Public Health 2022, 19(13), 7930; https://doi.org/10.3390/ijerph19137930 - 28 Jun 2022

Cited by 9 | Viewed by 2970

Abstract

Purpose of this study is to analyze factors affecting the healthy aging of the elderly with chronic diseases living in the community according to the worldwide aging phenomenon in line with the WHO’s healthy aging strategy. The subjects were 116 elderly aged 65 [...] Read more.

Purpose of this study is to analyze factors affecting the healthy aging of the elderly with chronic diseases living in the community according to the worldwide aging phenomenon in line with the WHO’s healthy aging strategy. The subjects were 116 elderly aged 65 years or up with one or more chronic diseases and residing in four cities. The collected data were analyzed by using the descriptive statistics, t-test, ANOVA, Pearson’s correlational coefficients, and stepwise multiple regression. The healthy aging of subjects showed positive correlations with the health status (r = 0.68, p < 0.001), gerotranscendence (r = 0.64, p < 0.001), self-efficacy (r = 0.65, p < 0.001), and social support (r = 0.47, p < 0.001), while the healthy aging and depression (r = −0.58, p < 0.001) showed a negative correlation. The factors affecting the healthy aging were health status (β = 0.24, p = 0.004), self-efficacy (β = 0.28, p < 0.001), education (β = −0.11, p = 0.057), exercise (β = 0.17, p = 0.003), gerotranscendence (β = 0.22, p = 0.004), and depression (β = −0.19, p = 0.009), and the explanatory power of those variables was 68.2%. Thus, it would be necessary to provide an intervention for the elderly that could habituate health-related education and exercise, maintain good health status, lower depression, aid control of themselves through the gerotranscendence, and increase self-efficacy. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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10 pages, 291 KiB

Open AccessArticle

Tips for Managing Ethical Challenges in Advance Care Planning: A Qualitative Analysis of Japanese Practical Textbooks for Clinicians

by Yoshihisa Hirakawa, Kaoruko Aita, Mitsunori Nishikawa, Hidenori Arai and Hisayuki Miura

Int. J. Environ. Res. Public Health 2022, 19(8), 4550; https://doi.org/10.3390/ijerph19084550 - 9 Apr 2022

Cited by 1 | Viewed by 2612

Abstract

(1) Background: While advance care planning (ACP) provides healthcare professionals with valuable tools to meet patients’ needs in a person-centered manner, several potential ethical challenges are inherent to the process. However, recent studies have largely focused on ACP practicalities such as implementation, execution, [...] Read more.

(1) Background: While advance care planning (ACP) provides healthcare professionals with valuable tools to meet patients’ needs in a person-centered manner, several potential ethical challenges are inherent to the process. However, recent studies have largely focused on ACP practicalities such as implementation, execution, and completion rather than on the ethical challenges that clinicians routinely encounter in ACP practices. (2) Research question/aim/objectives: This study aimed to identify tips for clinicians managing ethical challenges in ACP practices. (3) Methods: It performed a brief search for all Japanese published books pertaining to ACP practice available as of January 2021 using the keywords “advance care planning (ACP)” and “autonomy” and analyze the content of nine practical ACP textbooks for clinicians. (4) Results: Two major themes capturing the essential recommendations for managing ethical challenges in ACP were ultimately identified, namely interprofessional ethics and informed consent. (5) Conclusion: The findings suggested tips for managing ethical challenges in ACP: refer to ethical frameworks for interprofessional collaboration and ethical decision making, assess decision-making capacity of family substitute decision makers and one’s eligibility for the role, understand the standard process of informed consent and how to handle situations when the patient are not well informed about the diagnosis and prognosis of non-cancer illness. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

Review

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20 pages, 743 KiB

Open AccessReview

A Systematic Review of Qualitative Research Literature and a Thematic Synthesis of Older LGBTQ People’s Experiences of Quality of Life, Minority Joy, Resilience, Minority Stress, Discrimination, and Stigmatization in Japan and Sweden

by Anna Sofia Bratt, Ann-Christine Petersson Hjelm, Matilda Wurm, Richard Huntley, Yoshihisa Hirakawa and Tsukasa Muraya

Int. J. Environ. Res. Public Health 2023, 20(13), 6281; https://doi.org/10.3390/ijerph20136281 - 3 Jul 2023

Cited by 1 | Viewed by 3050

Abstract

There is a lack of research on older lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adults. This systematic review aimed to synthesize Japanese and Swedish qualitative research on LGBTQ adults aged 60 years or older following the Preferred Reporting Items for Systematic Reviews [...] Read more.

There is a lack of research on older lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) adults. This systematic review aimed to synthesize Japanese and Swedish qualitative research on LGBTQ adults aged 60 years or older following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Japanese and Swedish articles, published in English, were searched across ASSIA, CINAHL, Medline, PsychINFO, PubMed, Scopus, and Sociological Abstracts databases. Additional searches were conducted to include studies in Japanese or Swedish. There were no papers from Japan, whereas five from Sweden were reviewed. One article was excluded due to the wrong phenomenon. Four articles were included, involving 48 participants aged 60–94 years. We summarized the findings using a deductive thematic synthesis. Two major themes emerged: (a) quality of life, minority joy, and resilience (positive aspects), and (b) discrimination, stigmatization, and minority stress (negative aspects). The participants wished to be acknowledged for their own assets and unique life histories, and to be treated as everyone else. They emphasized the importance of knowledge of LGBTQ issues among nursing staff, so that older LGBTQ people are treated in a competent and affirmative way. The study revealed several important topics for understanding older LGBTQ adults’ life circumstances and the severe lack of qualitative studies in Japan and Sweden. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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17 pages, 1872 KiB

Open AccessReview

Access to Geriatric Disability Care in India: A Roadmap for Research

by Priyadarshini Chidambaram, S. D. Sreeganga, Anupama Sanjeev, Sarah Shabbir Suwasrawala, Suman Gadicherla, Lalitha Krishnappa and Arkalgud Ramaprasad

Int. J. Environ. Res. Public Health 2022, 19(16), 10018; https://doi.org/10.3390/ijerph191610018 - 14 Aug 2022

Cited by 1 | Viewed by 1965

Abstract

This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access [...] Read more.

This paper presents an ontological review of the global research on access to geriatric disability care and a roadmap for future research to address the problem in India. First, the dominant research focus is on resources (human, financial, and spatial) that affect access to disability care; there is little focus on informational and technological resources. Second, functional disabilities are the dominant focus of the research, followed by cognitive, mental, and locomotor disabilities; there is little focus on speech, hearing, and visual disabilities. Third, barriers, inhibitors, and catalysts of physical access are the dominant focus, with relatively less focus on virtual access; there is very little emphasis on the drivers to access. Fourth, the primary, although not dominant, focus is on access for urban and rural populations; there is very little focus on access for underserved and indigenous populations. Future research must address these gaps systematically to improve access. This paper adds: (a) a systemic framework for the study of an important, complex, emerging problem; (b) a systematic review of the global research on the problem; and (c) a research roadmap to address the emerging problem in India. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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Other

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16 pages, 2226 KiB

Open AccessSystematic Review

Opioid Prescription Method for Breathlessness Due to Non-Cancer Chronic Respiratory Diseases: A Systematic Review

by Yasuhiro Yamaguchi, K.M. Saif-Ur-Rahman, Motoko Nomura, Hiromitsu Ohta, Yoshihisa Hirakawa, Takashi Yamanaka, Satoshi Hirahara and Hisayuki Miura

Int. J. Environ. Res. Public Health 2022, 19(8), 4907; https://doi.org/10.3390/ijerph19084907 - 18 Apr 2022

Cited by 6 | Viewed by 3736

Abstract

A previous pooled analysis demonstrated significant relief of breathlessness following opioid administration in patients with chronic obstructive pulmonary disease. However, in clinical practice, it is important to know the characteristics of patients responding to opioids, the best prescription methods, and the evaluation measures [...] Read more.

A previous pooled analysis demonstrated significant relief of breathlessness following opioid administration in patients with chronic obstructive pulmonary disease. However, in clinical practice, it is important to know the characteristics of patients responding to opioids, the best prescription methods, and the evaluation measures that can sufficiently reflect these effects. Thus, we performed a systematic review of systemic opioids for non-cancer chronic respiratory diseases. Fifteen randomized controlled studies (RCTs), four non-randomized studies, two observational studies, and five retrospective studies were included. Recent RCTs suggested that regular oral opioid use would decrease the worst breathlessness in patients with a modified Medical Research Council score ≥ 3 by a degree of 1.0 or less on a scale of 1–10. Ergometer or treadmill tests indicated mostly consistent significant acute effects of morphine or codeine. In two non-randomized studies, about 60% of patients responded to opioids and showed definite improvement in symptoms and quality of life. Furthermore, titration of opioids in these studies suggested that a major proportion of these responders had benefits after administration of approximately 10 mg/day of morphine. However, more studies are needed to clarify the prescription method to reduce withdrawal due to adverse effects, which would lead to significant improvements in overall well-being. Full article

(This article belongs to the Special Issue Care and Services in Healthy Aging)

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