Health and Other Aspects of the Quality of Life of Older People

Celebrating the United Nations' International Year of Older Persons, in September 1999 a survey research project was undertaken throughout the Northern Interior Health Region (NIHR) of British Columbia. A total of 875 people completed 23-page questionnaires, the average age of the respondents was 69 and the range ran from 55 to 95 years. Responses to the SF-36 questionnaire indicated that for male respondents aged 55–64, the mean score for the 8 dimensions was 74.4. This mean was practically identical to that of the United States norm for such people (74.5) and lower than that for the United Kingdom (77.4). For male respondents aged 65 and older, the mean was 68.3. This was numerically higher but again practically the same as that of the norm for the United States (68.1). For females aged 55–64, the mean score for 8 dimensions was 73. This was superior to that of the United States norm of (70.6) for such people and lower than that for the United Kingdom (74.6). For female respondents aged 65 and older, the mean score was 65.4. This was practically identical to that of the United States (65.5).Comparing 18 average figures for our respondents on satisfaction with specific domains of life (e.g., financial security, health, friendships) and life as a whole with those of average adults in Prince George in November 1999, we found that in all but two cases the older people's scores were higher. Only in the cases of satisfaction with health and overall happiness were older people's scores lower, and the differences were not statistically significant.Eleven percent of our respondents reported that they had been a victim of a crime in the last year, compared to 38% in our 1997 adult victimization survey. Older people had a more benign view than ordinary adults of the growth of crime in their neighbourhood and city, although exactly 64% of both groups thought that crime had increased in Canada. Although older people had a more optimistic view than other adults of the increase in crime in their neighbourhoods, fewer of the former than the latter felt safe out at night. Nevertheless, compared to adults surveyed in 1997, the behaviour of respondents in our survey of older people was not as constrained by concerns of criminal victimization.Two or three of the 8 SF-36 health dimensions explained 37% of the variation in life satisfaction scores, 34% of variation in happiness scores, 34% in satisfaction with the overall quality of life scores and 22% in satisfaction with one's overall standard of living. In every case, Mental Health was the dimension that had the greatest impact on our four dependent variables.When all of our potential predictors were entered into a regression equation simultaneously, we found that they could explain 60% of the variance in life satisfaction scores, 44% in happiness scores, 58% in satisfaction with the overall quality of life scores and 59% in satisfaction with one's overall standard of living scores.     

The Curious Case of Self‐Interest: Inconsistent Effects and Ambivalence toward a Widely Accepted Construct

Self‐interest is widely accepted as a powerful motivator by both academics and laypeople alike. However, research surrounding the self‐interest motive paints a complicated picture of this most important psychological construct. Additionally, research on the social desirability of self‐interest has revealed that despite its widespread acceptance, people do not readily accept that self‐interest drives their own behaviors. This paper reviews the literature on self‐interest and reveals several curious features surrounding its actual effect on helping behaviors, political attitudes and voting, and people's apparent ambivalence toward self‐interest as a motive. It is possible that norms against the expression of self‐interestedness evolved, creating ambivalence towards this widely accepted construct, subsequently affecting its expression on many human behaviors.     

Health Self-management Among Older Prisoners: Current Understandings and Directions for Policy,Practice, and Research

The population of aging prisoners has increased significantly over the past several decades, resulting in concerns about the criminal justice system’s ability to address the needs of prisoners and parolees with chronic health conditions. This is troubling, given the health disparities among incarcerated populations. Health self-management has become a strategy within the community-based health care industry to improve health services and outcomes while reducing health care costs for nonincarcerated individuals with chronic conditions. However, to date little research has focused on the practice or promotion of health self-management among current and former incarcerated populations. This article highlights current understandings about chronic health self-management among older prisoners and parolees, with an emphasis on the potential benefits and current challenges in promoting their health self-management practices. Finally, specific recommendations are made for promoting health self-management for these populations through social work practice, policy advocacy, and research to achieve goals in improving health outcomes and reducing healthcare costs.     

Adventure Therapy: Nondeliberative Group Work in Action

ABSTRACT

Nondeliberative group work allows group members to generate their own solutions and provides experiential opportunities to transfer learning to life outside of a therapeutic setting. Adventure therapy is explored as a tool for engaging groups in a nondeliberative manner. The theoretical underpinnings of adventure therapy are presented and contextualized within the larger framework of experiential education. Specific methods and models of adventure work are presented and considered in relationship to nondeliberative social work with groups. Two case examples are presented to illustrate the nondeliberative nature of adventure therapy.     

Developing visibility for aging in social work: the first NGSWC

In March 2001, the Council on Social Work Education's (CSWE) Strengthening Aging and Gerontology Education for Social Work (SAGE-SW) project published an action agenda for social work and aging (CSWE/SAGE-SW, 2001). CSWE SAGE-SW, funded by the John A. Hartford Foundation from 1998 to 2004, had several charges in the first phase of funding, including the gathering of data through a thorough review of literature, focus groups, surveys and a variety of activities to garner expert input. This agenda, often referred to as the Blueprint, identified a number of serious issues regarding the lack of attention, preparation, leadership and interest in aging within the social work profession. It also provided some recommended actions to address these issues and help set the stage for the creation of the National Gerontological Social Work Conference. What were the issues at hand and why might a National Gerontological Social Work Conference (NGSWC) address some of these issues?     

The molecular basis of age-related kidney disease

Renal disease affects 11% of people in the United States over the age of 65, not including those with diabetes or hypertension. Although glomerular disease is the most common underlying etiology of age-related renal dysfunction, the cause of glomerular disease and whether it is the only contributor to renal failure are not known. Our studies in female mice show that renal disease in the postmenopausal period is associated with progressive glomerular enlargement and scarring, as well as abnormal renal function. To study the underlying causes of aging-related glomerular disease, we isolated and characterized glomerular smooth muscle (mesangial) cells from female mice of various ages. We found that the cells from older mice exhibit a variety of phenotypic changes, including increased concentrations of p27, a protein that serves to inhibit progression from the G1 to the S phase of the cell cycle. Because the bone marrow (BM) contains mesangial cell progenitors that can transfer the donor glomerular phenotype (normal or diseased) to recipients, we exchanged BM between postmenopausal and premenopausal mice and found that aging-related glomerular enlargement and scarring are transferred to young recipient glomeruli. In addition, BM from normal, young donors led to the regression of aging-related glomerular disease in postmenopausal recipients; namely, both glomerular enlargement and scarring were reduced. Thus, aging-related glomerular disease is an entity distinct from all other causes of renal disease, is characterized by phenotypic changes in mesangial cell progenitors, and is reversible when the phenotype of the progenitors is returned to normal.     

Negotiating Interorganizational Orders*

Strauss' (1978) negotiation paradigm is used to analyze interorganizational relations leading to development of a complex of eleven rehabilitation agencies. Analysis is based on records over a twenty-five year period and four years of participant observation and interviewing. The structural context for the negotiations is described in terms of over-lapping societal, communal, interorganizational, organizational, and interpersonal levels. The analysis points out the importance of covert, informal negotiations to interorganizational relations. The negotiators who initiated the process employed a strategy of multiple-linked negotiations in which they attempted to select negotiators from the other organizations and the issues to be negotiated. Stakes were manipulated according to a cost-reward-involvement formula. Problematic issues were dealt with in informal covert negotiations which preceded overt negotiations in a peer type council. Consideration of the negotiation process aids in understanding several problems in interorganizational relations: power and autonomy and the consequences of interlocking directorates. The negotiated order approach suggests several lines of additional research.     

The experience of returning to work

The purpose of this qualitative study was to explore from an environmental perspective the experiences of returning to work of former unemployed sickness absentees. Five separate focus-group interviews were carried out with themes concerning different environmental areas. The findings showed that the participants in their process of being off work and then attempting returning to work experienced a personal transition manifesting itself as a negative self-image, change of life-rhythm and restrictions in their roles and activities. In their progression, the participants experienced a need for reorientation and expressed feelings of alienation, and for that reason felt need of support from a network, especially a professional one. Regarding attitudes in society, the participants reported experiences of social stigmatization, both in mass media and in their immediate social environment, and an increasing egocentricity among their fellow-workers. They perceived their progression back to work as a 'time quarantine' and as a long and destructive wait for support. The findings indicate that the phenomenon of 'returning to work' after unemployment and sick leave could not be reduced to a single issue. It should rather be seen as a dynamic problem with individual and structural, environmental aspects.     

Job insecurity, coping resources and personality dispositions in occupational strain

This paper presents research on the relationships between the work-related stressor of perceived job insecurity and various indicators of occupational strain, taking into account employees' personality dispositions (trait negative and positive affectivity) and coping resources. Respondents were 222 Australian public servants surveyed during organizational restructuring that involved downsizing and threat to job certainty. The research was formulated within an adaptation of Osipow, Doty, and Spokane's (1985) framework of stress-strain-coping that included the possible direct as well as moderating effects of personality dispositions in reporting occupational strain (Parkes, 1990). Findings from hierarchical regression analyses indicate consistent significant independent effects of personality dispositions, coping resources and perceived job insecurity on various indicators of strain. There was also support for the moderating roles of negative affectivity and self-care in the relation between perceived job insecurity and physical strain. Implications for the role of dispositional factors, especially negative affectivity, and the utility of various coping resources in accounting for occupational strain in times of threatened job security are discussed.