Investing in the future - identifying participants in an educational program for middle-aged and older adults

With the aging of societies, gerontological issues have become increasingly relevant. Within health education research, however, issues related to aging remain underrepresented. It is not yet understood whether and by what means people prepare for their aging. This article seeks to identify those who invest in the future by examining the reach of the educational program ‘In anticipation of the golden years’. We studied what motivated participants to enroll, and collected demographic, psychological and social network characteristics from the 158 individuals (mean age 61.5 years) who had signed up for the program. These data were compared with data from large-scale surveys of the aging population in order to examine the representativeness of program participants. The majority of participants' motives corresponded very well with the aims of the program. Comparison of demographic, psychological and social characteristics revealed that, in general, participants enjoyed greater psychological resources than in the population, while they were less advantaged with respect to their personal situation (predominantly household composition and subjective health) and social relationships. Our findings suggest that future investment in relation to aging is a well-accepted idea that appeals to individuals who exhibit a specific combination of resources and risk factors

Die Verwendung struktureller Allografts als Strut Grafts bei der operativen Therapie periprothetischer Knochendefekte und Frakturen am proximalen und diaphysären Femur

Mittels Strut Graft Osteosynthesen wurden 71 Probanden (54 Frauen, 17 Männer) mit periprothetischen proximalen und diaphysären Femurdefekten und/oder -frakturen operativ behandelt, davon 65 Probanden in Onlay- und fünf in Inlay-Technik. Alle Probanden wurden prä- und postoperativ klinisch und radiologisch standardisiert untersucht und ihre Daten analysiert. Das Durchschnittsalter betrug 67,5 Jahre (48 bis 88 Jahre), der mittlere Beobachtungszeitraum lag bei 3,7 Jahren (vier Monate bis elf Jahre). 33 Probanden wiesen periprothetische femorale Knochensubstanzdefekte mit Implantatlockerung auf, fünf Typ 2, 23 Typ 3 und fünf Typ 4 nach der Paprosky Defektklassifikation. 38 Probanden wiesen eine periprothetische Femurfraktur auf, 15 Typ B1, fünf Typ B2, elf Typ B3 und sieben Typ C nach der Vancouver Klassifikation. Die Einheilungsrate der Strut Grafts lag im Gesamtkollektiv bei 98,6 %, die Resorptionsrate bei 9,9 %. Alle Probanden zeigten postoperativ eine stabile Integration des Prothesenschaftes, 55 Prothesenschäfte waren knöchern integriert und 16 fibrös stabil ohne Beschwerdesymptomatik der Probanden. Der Mittelwert im Harris Hip Score stieg von präoperativ 13,1 auf postoperativ 84,1 Punkte. Die Rate der allgemeinen postoperativen Komplikationen lag bei 12,6 %. Alle Probanden mit Defekttyp Vier nach Paprosky wurden mittels Strut Grafts in Inlay-Technik zur Querschnittsverkleinerung des Femur behandelt. Von diesen zeigten zwei Probanden eine knöcherne und drei Probanden eine fibrös stabile Integration des Prothesenschaftes. Die vorliegende Arbeit konnte zeigen, dass Strut Grafts eine dauerhafte Augmentation und Stabilisierung des insuffizienten femoralen Implantatlagers leisten können. Die Strut Graft Osteosynthese in Inlay-Technik bedarf noch weiterer Fallzahlen zur Überprüfung der Effektivität dieses Verfahrens

Limited results of group self-management education for rheumatoid arthritis patients and their partners: explanations from the patient perspective

This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were content analyzed with respect to motivation to participate and the effects of the program on them. The limited effects of the self-management program appear to be linked with low motivation to participate and to change health behavior. The data show that a decline in health and also stressful life events might be associated with the disappointing effects of the program. Three strategies were proposed for improving the program’s effects: (a) provide information about the program in advance to ensure that patients have appropriate expectations. (b) Enhance intrinsic motivation to change health behavior by counseling techniques. (c) Tailoring with respect to motivation and current concerns could help to form more homogeneous groups or could be the basis for a tailored online intervention

Workshop Omgaan met persoonlijke doelen

Persoonlijke doelen geven richting en zin aan het leven. Het formuleren en nastreven van doelen vergroot betrokkenheid met de omgeving en het leven in het algemeen. Gezegdes en uitspraken zoals “Voor een schip dat niet weet waar het naartoe gaat, is geen enkele wind de goede” en “Het geheim van het mens-zijn is niet om te leven, maar om iets te hebben om voor te leven” laten dit uitstekend zien. Verder is het gevoel in staat te zijn doelen te bereiken en daarmee tot op zekere hoogte controle uit te oefenen over de omgeving verbonden met een positief zelfbeeld en positieve gevoelens. De perceptie van vooruitgang, dichter komen bij het doel, wordt als belonend en positief ervaren. Naast deze aangename functie van persoonlijke doelen kunnen ze soms ook behoorlijk lastig zijn, namelijk als het bereiken onwaarschijnlijker wordt en doelen ernstig bedreigd worden. Dit kan bijvoorbeeld door het optreden van een chronische ziekte of veranderingen in de levenssituatie gebeuren, waardoor het behalen van persoonlijke doelen moeilijker of onmogelijk wordt. Op basis van theorieën over doelmanagement zullen de deelnemers vertrouwd gemaakt worden met vier doelmanagement strategieën. We zullen U in deze workshop laten ervaren op welke manier men kan omgaan met bedreigde doelen, hoe men ook in moeilijke situaties doelmanagement kan toepassen en welke oefeningen men kan gebruiken om de op dat moment de beste strategie te kiezen

Using the Three-Step Test Interview to understand how patients perceive the St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C)

Purpose The aim of this study was to assess the experiences of patients with chronic obstructive pulmonary disease (COPD) while they were completing the St. George’s Respiratory Questionnaire for COPD patients (SGRQ-C), using qualitative research methods. Methods Twenty Dutch COPD patients were recruited through pulmonary physicians [13 women; mean age = 63.3 years (SD = 11.4)]. A trained interviewer applied the Three-Step Test Interview which allowed the interviewer to follow the thought process of the patient filling out the SGRQ-C. The official Dutch translation of the SGRQ-C was used. Results Patients missed a recall period for the Symptoms subscale; were uncertain how to interpret specific words and phrases like “good days”, “games”, and “housework”; were confused by long-item stems that included a list of activities; and were frustrated by the dichotomous format used for the majority of SGRQ-C items (true/false). Conclusions Overall, patients were satisfied with the SGRQ-C. Nevertheless, making minor adjustments could further increase its quality. This includes reintroducing a recall period in the first set of items such as used in the previous version and splitting up items consisting of multiple activities. Furthermore, we recommend using the same response format (4 or 5 response categories) for all items

Exploring preferences for domain-specific goal management in patients with polyarthritis: what to do when an important goal becomes threatened?

Usually priorities in goal management—intended to minimize discrepancies between a given and desired situation—are studied as person characteristics, neglecting possible domain-specific aspects. However, people may make different decisions in different situations depending on the importance of the personal issues at stake. Aim of the present study therefore was to develop arthritis-related vignettes to examine domain-specific goal management and to explore patients’ preferences. Based on interviews and literature, situation-specific hypothetical stories were developed in which the main character encounters a problem with a valued goal due to arthritis. Thirty-one patients (61 % female, mean age 60 years) evaluated the face validity of the newly developed vignettes. Secondly, 262 patients (60 % female, mean age 63 years) were asked to come up with possible solutions for the problems with attaining a goal described in a subset of the vignettes. Goal management strategies within the responses and the preference for the various strategies were identified. The 11 developed vignettes in three domains were found to be face-valid. In 90 % of the responses, goal management strategies were identified (31 % goal maintenance, 29 % goal adjustment, 21 % goal disengagement, and 10 % goal re-engagement). Strategy preference was related to domains. Solutions containing goal disengagement were the least preferred. Using vignettes for measuring domain-specific goal management appears as valuable addition to the existing questionnaires. The vignettes can be used to study how patients with arthritis cope with threatened goals in specific domains from a patient’s perspective. Domain-specific strategy preference emphasizes the importance of a situation-specific instrument

A goal management intervention for polyarthritis patients: rationale and design of a randomized controlled trial

Background A health promotion intervention was developed for inflammatory arthritis patients, based on goal management. Elevated levels of depression and anxiety symptoms, which indicate maladjustment, are found in such patients. Other indicators of adaptation to chronic disease are positive affect, purpose in life and social participation. The new intervention focuses on to improving adaptation by increasing psychological and social well-being and decreasing symptoms of affective disorders. Content includes how patients can cope with activities and life goals that are threatened or have become impossible to attain due to arthritis. The four goal management strategies used are: goal maintenance, goal adjustment, goal disengagement and reengagement. Ability to use various goal management strategies, coping versatility and self-efficacy are hypothesized to mediate the intervention’s effect on primary and secondary outcomes. The primary outcome is depressive symptoms. Secondary outcomes are anxiety symptoms, positive affect, purpose in life, social participation, pain, fatigue and physical functioning. A cost-effectiveness analysis and stakeholders’ analysis are planned. Methods/design The protocol-based psycho-educational program consists of six group-based meetings and homework assignments, led by a trained nurse. Participants are introduced to goal management strategies and learn to use these strategies to cope with threatened personal goals. Four general hospitals participate in a randomized controlled trial with one intervention group and a waiting list control condition. Discussion The purpose of this study is to evaluate the effectiveness of a goal management intervention. The study has a holistic focus as both the absence of psychological distress and presence of well-being are assessed. In the intervention, applicable goal management competencies are learned that assist people in their choice of behaviors to sustain and enhance their quality of lif