Health,Quality of Care and Quality of Life: A Case of Frail Older Adults

This study explores the relationship between health, quality of care of geriatric case management and quality of life for the purpose of furthering the understanding of the relationship between quality of life and geriatric case management. Using survey data from a group of frail older adults, this study assesses the relative merit of two mediation hypotheses: one considering health as a mediator for quality of care of geriatric case management and quality of life, and the other considering quality of care of geriatric case management as a mediator for health and quality of life. The study findings show that quality of care of geriatric case management, measured by client satisfaction, was not a mediator between health and quality of life (measured by life satisfaction). There was a significant positive association between quality of care of geriatric case management and quality of life. Although the significant association between quality of care of geriatric case management and quality of life could not be mediated by either self-rated health or self-reported physical activity levels, it was completely mediated by health satisfaction. These findings provided preliminary empirical evidence to support a significant relationship between quality of care of geriatric case management and quality of life.     

Service and Life Quality: The Case of Palermo

The research aims at analysing the ``quality' of some services offered to the citizens by the Commune of Palermo. The data available were gathered thanks to a sampling survey carried out in October 1997. The sample is made up of 1008 residents in the city of Palermo and is proportionally stratified according to the quarter of residence. Information was gathered by means of a telephone questionnaire. The answering rate was rather high and a great interest in the subjects dealt was taken.The research wants to individuate the degree of efficiency of the Commune of Palermo, also at administrative level, with some questions concerning the municipal council, taking the expectations of the citizens of the city into account through an analytic survey of the indicators measuring the judgement of the citizen towards the main services. This result will be the starting point of an exhaustive analysis aiming at the individuation of the ``quality of life' in Palermo, which is tightly connected with the services offered.     

Basic Minimum Needs,Quality of Life and Selected Correlates: Explorations in Villages in Northern India

For those involved in international development, one of the major goals is an improvement in the quality of life of the poor. Bhargava and Chakrabati (1992: 133) see the “primary objective of development at any given time is to improve the quality of life”. Indeed, the mission statement for an international development organization explicitly commits itself to the improvement of the quality of life for the “poorest of the poor” (DID, 1994). Social indicators, as “transeconomic” measures of quality of life, have “become an integral part of 'development indicators”' (Kao and Liu, 1984: 400; see, also Kahn, 1991). The connection between quality of life and development extends beyond the Third World. For example, in the U.S. Myers (1987) found quality of life influenced inmigration to Austin, Texas, thus affecting its economic development. Undoubtedly the majority of the connections between social indicators and development has been examined at the macro, or national levels using economic, health, education and other objective, comparative indices. Recognizing that such measures as GNP are oftentimes inadequate, assorted indices have been derived to gauge the changes in social development over time, e.g., the well-known Physical Quality of Life Index (PQLI) constructed by the Overseas Development Council (Morris, 1976). Many of these tend to focus on objective, material indicators (commodity possessions) as opposed to the more subjective ones (Anand and Ravallion, 1993). It is not the purpose of this paper to examine the various critics' arguments about the strengths and weaknesses of extant macro versus micro indices, but rather to lend support for the general need to assess development and social change through social indicators, whether macro or micro, objective or subjective. Ultimately, the purpose of the assessment should guide which social indicators are selected. The purpose of this paper is to examine several issues arising from the linkages between development efforts and quality of life (QOL). Using empirical data which were gathered to evaluate a community development project in the Garhwal region of Northern India, several issues, germane to both social indicators and development, will be investigated. These include: (1) the relationship between “Basic Minimum Needs” (BMNs) and QOL, (2) some methodological innovations for measuring both BMNs and QOL, and (3) selected correlates of BMNs and social indicators of QOL for Garhwali villagers. Before describing the project and its findings, we will first place it in the overall development context.     

Responding to Social Service and Health Care Needs of Aging Women Veterans

ABSTRACT

This is a study about aging women veterans who served in the military during the 1940s, 1950s and 1960s. The Veterans Administration (VA) represents a formal network of health and support services that offers a wide range of benefits for veterans. However, older women veterans may not be aware of, or benefit from, all that may be available to them. The purpose of this study was to learn about aging women veterans' knowledge and utilization of services and benefits available through the VA. Telephone interviews were conducted in April 1998 with 220 women veterans in Massachusetts who were age 60 + years.

There was generally strong identification with veterans' organizations among the women surveyed. These women veterans were likely to receive medical care—a major benefit available through the VA. The benefits veterans were least likely to know about included services that may be particularly relevant and helpful to an aging veteran, such as long-term care and home adaptation services. Strategies are suggested to enhance outreach efforts to aging veterans.     

老年人口健康生活质量评价原则的探讨

老年人口健康生活质量的评价是社会养老保障决策过程中的重要依据之一。目前 ,尽管各国都进行了许多有关的评价研究 ,但老年人口生活质量的评价还没有较成熟的权威性量表 ,各种方法各有利弊。本文结合传统的老年人健康状态和功能评价 ,以及老年人口的特点 ,探讨了老年人健康状态和功能评价的思路和内容     

Urban Quality of Life: A Case Study of Guwahati

This paper studies quality of life (QOL) in urban environment. The term environment has been used in broader sense, which includes physical, social and economic environment. A framework has been proposed which posits that QOL comprises objective condition of living and satisfaction from such living condition constitutes QOL. Such objective condition refers to objective QOL and satisfaction refers to subjective QOL. Dimension of QOL has been found to be multi dimensional. It has been found that both objective and subjective condition is important dimension of QOL. But correlation between objective and subjective QOL has been found not to be high. At the same time it has been found that satisfaction from condition of traffic is the lowest among all satisfaction variables.     

Sexual Orientation and Sexual Health Care Needs: A Comparison of Women Beneficiaries in Outpatient Military Health Care Settings

ABSTRACT

The objectives of this study are to compare the sexual concerns, interest and experiences in discussing these concerns with their doctor for women of “Only Men” and “Some to Only Women” sexual orientation. A survey was mailed to women patients from two military outpatient settings, with 1,196 women responding. Of eligible respondents (N = 1,170), 90% reported “Only Men” and 10% reported “Some to Only Women” sexual orientation. Sexual concerns varied by sexual orientation, while interest and experience in discussing sexual concerns and desire for physicians to initiate the topic differed minimally. Women with “Some to Only Women” sexual orientation have both similar and differing sexual concerns compared to “male-only” oriented women. Larger primary care patient-based studies of sexual health care needs of sexual minorities are needed.     

Health,Quality of Homecare Services and Quality of Life: A Case of Frail Older Immigrant Adults

The theory about missing links of economic growth often lags behind the empirical estimations of such links. A consensus has emerged that ethnic fractionalization has a negative impact on growth, also when controlled for income inequality. Often, although implicitly, the assumed channel is social cohesion. We analyse the effect of fractionalization on social cohesion with a different inequality measure, namely a social measure of inequality: the Inclusion of Minorities Index. Our results indicate that it is social exclusion, which reduces social cohesion, rather than diversity as such. We conclude that future studies of social cohesion and its relation to growth may benefit from using measures of social exclusion next to ethnic diversity.     

Mental Health of Transgender People in Hong Kong: A Community-Driven,Large-Scale Quantitative Study Documenting Demographics and Correlates of Quality of Life and Suicidality

A community-driven survey of 106 transgender people (the first such survey in Hong Kong) showed that: (1) more than half the sample (50.9%) had a university degree or higher qualification; (2) despite this, 43.4% had a monthly income below HK$6,000 (about USD$775); (3) 66% reported “fair” or “poor” quality of life; (4) 67% of the sample (87.1% of respondents aged 15–24 years) had contemplated suicide; and (5) 20.8% of the sample (35.5% of respondents aged 15–24 years) had attempted suicide. It was found that (1) those who were single, had a lower monthly income, and identified as transgender women reported lower quality of life; and (2) those who were younger and on a lower income expressed higher suicidality. The findings suggest that service providers and policy makers urgently need to address the mental health needs of transgender people, particular younger transgender people.     

Unpacking Self-Rated Health and Quality of Life in Older Adults and Elderly in India: A Structural Equation Modelling Approach

The Study on global AGEing and adult health (SAGE) aims at improving empirical understanding of the health and well-being of older adults in low- and middle-income countries. A total of 321 adults aged 50 years and older were interviewed in rural Pune district, India, in 2007. We used Structural Equation Modelling (SEM) to examine the pathways through which social factors, functional disability, risk behaviours, and chronic disease experience influence self-rated health (SRH) and quality of life (QOL) amongst older adults in India. Both SRH and QOL worsened with increased age (indirect effect) and limitations in functional ability (direct effect). QOL, socio-economic status (SES), and social networking had no significant effect on SRH. Smoking was associated with the presence of at least one chronic illness, but this did not have a statistically significant effect on SRH. Higher social networking was seen amongst the better educated and those with regular income, which in turn positively affected the QOL rating. QOL had a direct, but statistically not significant, effect on SRH. In conclusion, the indirect effects of age on SRH mediated through functional ability, and the effects of SES on QOL mediated through social networking, provide new understanding of how age and socio-economic status affect SRH and QOL. By allowing for measurement errors, solving for collinearity in predictor variables by integrating them into measurement models, and specifying causal dependencies between the underlying latent constructs, SEM provides a strong link between theory and empirics.     

Health-Related Quality of Life of Chinese Earthquake Survivors: A Case Study of Five Hard-Hit Disaster Counties in Sichuan

As one of the most destructive natural disasters, earthquakes affect the health of survivors. The devastating earthquakes that hit Sichuan, China have aroused the concern of domestic and international scholars. The health-related quality of life (HRQOL) of survivors also requires substantial research. Studies on impact factors, such as gender, age, monthly income, and education, have become controversial. The subjects in this study are the people of five hard-hit disaster counties in Sichuan Province, namely, Wenchuan, Qingchuan, Mianzhu, Lushan, and Dujiangyan. A preliminary survey was conducted in May and June 2013 in areas badly hit by the earthquake in Sichuan, China. A total of 2000 questionnaires were distributed, and 1672 of which were received, yielding a recovery rate of 83.6 %. To further complement and corroborate the conclusions, a follow-up survey was conducted in October and November 2013, where 1526 effective questionnaires were received. The analysis in this paper is mainly based on the first survey, and the collected data from the follow-up survey were used to perform a supplementary analysis. By analyzing data from five hard-hit areas in Sichuan and by establishing models, we drew the following conclusions: The results of analysis of variance and Tukey’s honestly significant difference tests revealed the following results. First, the results of two investigations indicate the HRQOL of earthquake survivors is relatively poor, especially in terms of general health (GH), mental health (MH), social functioning (SF), etc. However, results of the second survey indicate that the scores of all domains (except GH) have increased significantly, with the SF having the most significant increase. Second, the HRQOL scores of men are higher than those of women. Individuals with higher education or monthly income have higher HRQOL scores than those with lower education or income. Moreover, younger survivors have higher HRQOL scores than older survivors. Third, a positive correlation exists among the HRQOL domains of all survivors. Among all domains, the PF, RP, GH, MH, and VT of survivors have a very strong correlation. In addition, SF, BP, MH, and VT have a strong correlation. Other variables have a relatively weak correlation.     

Spiritual Needs and Quality of Life in Estonia

This paper reports on three field studies using the WHOQOL-100 and WHOQOL-BREF instruments that utilized three different samples (N = 1,801) to get a better understanding of how important the person’s spiritual needs are for quality of life. The most striking negative difference between the Estonian and World Health Organization samples was in the WHOQOL-100 spirituality domain. We found that the quality of life index significantly correlated with the WHOQOL-100 spirituality score. Also, spirituality was related to all quality of life domains (physical health, psychological well-being, level of independence, social relationships and environment). Regarding psychological well-being, spirituality correlated with self-esteem, positive feelings, and thinking, learning, memory, and concentration, on the other. Our findings suggest that spirituality occupies an important place in the person’s perception of their quality of life in a changing socio–economic environment as the one in Estonia.     

Adaptation and Dissonance in Quality of Life: A Case Study in Mekelle,Ethiopia

This study aimed to determine predictability of life satisfaction by focusing on social support, substance abuse, socio-demographic factors as well as received health services from medical and traditional centers in the elderly with dementia. The subjects were 1,210 non-institutionalized Malaysian elderly with cognitive problems. In addition, age, ethnicity, sex differences, marital status, educational level, social support, substance abuse and receiving health services were evaluated to predict the risk of falls in samples. Social support was measured by Lubben score. Substance abuse was referred to smoking per day, addiction to alcohol consumption as well as dependency to medications. Health care supports, which were received by individuals included medical and traditional treatments. Life satisfaction was measured by asking in general ‘Are you satisfied with your current life’. The multiple logistic regression analysis was used to determine the effects of contributing variables on life satisfaction in respondents. Approximately 83 % of subjects reported that they were satisfied with their current life. The results of multiple regression analysis showed that marital status (OR = 1.98), traditional treatments (OR = 0.43), social support (OR = 2.28) and educational level (OR = 1.79) significantly affected life satisfaction in samples (p < 0.05). Furthermore, age, ethnicity, sex differences, substance abuse and medical treatments were not significant predictors of life satisfaction (p > 0.05). It was concluded that social support, being married and education increased life satisfaction in subjects but traditional treatments decreased life satisfaction.     

中国老年人的空巢时间有多长?

在中国人口老龄化过程中,随着空巢老人比重的持续上升,老年人在空巢状态度过的时间也在不断延长.文章使用中国健康与养老追踪调查(CHARLS) 2011、2013年的数据和多状态生命表法,估计60岁及以上老年人的预期寿命和空巢预期寿命,及其性别、城乡和受教育程度差异.结果表明,中国老年人整个老年期中超过一半的余寿都处在空巢状态;女性老年人的空巢预期寿命高于男性老年人;农村老年人的空巢预期寿命高于城市老年人;而受教育水平越高,老年人空巢预期寿命也越长.另外,老年人的空巢预期寿命与他们当前所处居住状态有很大关系,当前处在空巢状态的老年人的空巢预期寿命及其占余寿比重都远远高于处于非空巢状态的老年人.     

我国老年人口失能判别及其对健康预期寿命影响分析

老年人口失能水平对健康预期寿命的测算具有重要影响,而不同数据来源的老年人口失能水平存在着较大差异。本文以经过模型生命表调整的2015年1%人口抽样数据所计算的生命表为基础,以2010年人口普查、2015年1%人口抽样调查、2015年CHARLS数据和2014年CLHLS数据为资料来源,探讨老年人口分年龄失能状况及其对健康预期寿命测算结果的影响。老年人失能率较大程度地影响着健康预期寿命及其性别年龄模式。无论是失能的主观评价指标还是客观评价指标,不同数据来源的高龄老人失能率差别较大;CHARLS数据中高龄老人失能率偏倚原因可能产生于调查过程中的系统误差,而非样本规模较小;CLHLS和CHARLS中的问卷访题设计也是影响失能程度判别的重要因素。因此,在理论和应用层面上探讨我国老年人口特别是高龄老人失能水平的差异及其原因,逐步形成共识是学界亟待解决的重要问题。     

社区居家养老服务质量模型研究——以上海市为例

文章在对上海市社区居家养老服务定性分析基础上,根据服务质量模型和理论,尝试构建社区居家养老服务的质量模型。研究结果表明,社区居家养老服务质量模型是一个包括助洁、助餐、助医和康乐服务质量4个子维度的二阶结构,现阶段科学合理地评估社区居家养老服务质量,应该从助洁、助餐、助医和康乐服务质量方面进行操作。应用该模型对上海市社区居家养老服务质量评价的结果表明,上海社区居家养老服务已经步入规范发展的轨道,基本实现了服务能力、服务执行的稳定性与一致性,具备了可靠性、响应性和可感知性等特点,但在通过个性化服务和专业人员队伍反映的移情性和保证性方面还存在一定的差距。     

A Mixed Method Approach to Quality of Life Research: A Case Study Approach

Increased use of qualitative and quantitative methods in quality of life projects necessitates an examination of how to effectively work within a mixed method framework. The research objectives of this paper are to (1) operationalize the two goals of mixed method research (confirmation and comprehension) and (2) develop a strategy for using mixed methods in quality of life research. Face-to-face interview (qualitative) and telephone survey (quantitative) data from the Community–University Institute for Social Research Quality of Life (CUISR QoL) project in Saskatoon, Saskatchewan were used for operationalization. Overall, confirmation and comprehension were challenging concepts to operationalize. Seven benefits and four guidelines were developed and are presented as dynamic, rather than definitive, structures.     

OECD国家老年照护质量控制研究

在增加老年照护服务供给的同时,OECD国家在照护质量控制方面进行了诸多探索,积累了丰富的经验,包括通过立法保护老年人被照护的权利以及明确政府在照护资源供给方面的责任;通过资格认证制度控制照护机构的标准和条件以及护理人员的职业素质;利用评估工具实现照护需求鉴定和照护服务供给的标准化;建立以消费者选择为主导的激励机制提高供应商改进服务质量的积极性.分析总结这些经验对中国积极应对老年照护问题具有重要的借鉴意义.     

Differences in the Health Care Needs and Service Utilization of Women in Nursing Homes: Comparison by Race/Ethnicity

ABSTRACT

The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey. The data were analyzed using GLM. The findings suggest that Native American women are the most impaired and Asian/Pacific Islander women are the least impaired. Additionally, very few women received mental health services despite their extensive need.     

文化的同化对加拿大老年人居住方式的影响

本文基于加拿大 1996年移民数据 ,利用单因素和多因素Logit模型分析方法 ,试图研究文化因素对老年人居住方式的影响。主要结论如下 :文化因素对老年人居住方式的选择有重要影响 ;文化的同化对移民居住方式的选择有显著作用 ,表现为移民时间越早的移民老年人独立居住的倾向越强 ;文化同化速度的快慢对不同种族来源的移民来说是不同的。该文认为 ,在未来相当长的时间内 ,与子女合住仍然是中国老年人居住方式的主流