Older People, Sense of Coherence and Community

Population ageing is a global trend and even though years added to life often are lived in good health; it will have an impact on healthcare, housing and facilities, and social security costs. Healthy ageing in place, especially in one’s own home and community, increasingly receives attention from health professionals, researchers, and policymakers. In this chapter, we first discuss the meaning of the concept of healthy ageing, and how Sense of Coherence contributes to this process. Next, we discuss the characteristics of the community in which older people live their lives and how the community can provide resources (GRR and SRR) to strengthen Sense of Coherence and hence perceived well-being and quality of life

A systematic review of interactive multimedia interventions to promote children's communication with health professionals: implications for communicating with overweight children

Background: Interactive multimedia is an emerging technology that is being used to facilitate interactions between patients and health professionals. The purpose of this review was to identify and evaluate the impact of multimedia interventions (MIs), delivered in the context of paediatric healthcare, in order to inform the development of a MI to promote the communication of dietetic messages with overweight preadolescent children. Of particular interest were the effects of these MIs on child engagement and participation in treatment, and the subsequent effect on health-related treatment outcomes. Methods: An extensive search of 12 bibliographic databases was conducted in April 2012. Studies were included if: one or more child-participant was 7 to 11 years-of-age; a MI was used to improve health-related behaviour; child-participants were diagnosed with a health condition and were receiving treatment for that condition at the time of the study. Data describing study characteristics and intervention effects on communication, satisfaction, knowledge acquisition, changes in self-efficacy, healthcare utilisation, and health outcomes were extracted and summarised using qualitative and quantitative methods. Results: A total of 14 controlled trials, published between 1997 and 2006 met the selection criteria. Several MIs had the capacity to facilitate engagement between the child and a clinician, but only one sought to utilise the MI to improve communication between the child and health professional. In spite of concerns over the quality of some studies and small study populations, MIs were found useful in educating children about their health, and they demonstrated potential to improve children’s health- related self-efficacy, which could make them more able partners in face-to-face communications with health professionals. Conclusions: The findings of this review suggest that MIs have the capacity to support preadolescent child-clinician communication, but further research in this field is needed. Particular attention should be given to designing appropriate MIs that are clinically relevant

‘Subjective resilience’: using perceptions to quantify household resilience to climate extremes and disasters.

How should we measure a household’s resilience to climate extremes, climate change or other evolving threats? As resilience gathers momentum on the international stage, interest in this question continues to grow. So far, efforts to measure resilience have largely focused on the use of ‘objective’ frameworks and methods of indicator selection. These typically depend on a range of observable socio-economic variables, such as levels of income, the extent of a household’s social capital or its access to social safety nets. Yet while objective methods have their uses, they suffer from well-documented weaknesses. This paper advocates for the use of an alternative but complementary method: the measurement of ‘subjective’ resilience at the household level. The concept of subjective resilience stems from the premise that people have an understanding of the factors that contribute to their ability to anticipate, buffer and adapt to disturbance and change. Subjective household resilience therefore relates to an individual’s cognitive and affective self-evaluation of their household’s capabilities and capacities in responding to risk. We discuss the advantages and limitations of measuring subjective household resilience and highlight its relationships with other concepts such as perceived adaptive capacity, subjective well-being and psychological resilience. We then put forward different options for the design and delivery of survey questions on subjective household resilience. While the approach we describe is focused at the household level, we show how it has the potential to be aggregated to inform sub-national or national resilience metrics and indicators. Lastly, we highlight how subjective methods of resilience assessment could be used to improve policy and decision-making. Above all, we argue that, alongside traditional objective measures and indicators, efforts to measure resilience should take into account subjective aspects of household resilience in order to ensure a more holistic understanding of resilience to climate extremes and disasters