Challenges to concordance: theories that explain variations in patient responses

Failing to establish a collaborative relationship between patient and health professional can be a significant obstacle to recovery. Julie Green and Rebecca Jester delve into the psychology behind patient responses and present methods to empower patients.This article was first published in the British Journal of Community Nursing, volume 24, issue 10.Published versio

The relationship between wealth and loneliness among older people across Europe: Is social participation protective?

Objective: 1. Examine the relationship between household wealth, social participation and loneliness among older people across Europe. 2. Investigate whether relationships vary by type of social participation (charity/volunteer work, sports/social clubs, educational/training course, and political/community organisations) and gender. 3. Examine whether social participation moderates the association between wealth and loneliness. Methods: Data (N = 29,795) were taken from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE), which was collected during 2013 from 14 European countries. Loneliness was measured using the short version of the Revised-University of California, Los Angeles (R-UCLA) Loneliness Scale. We used multilevel logistic models stratified by gender to examine the relationships between variables, with individuals nested within countries. Results: The risk of loneliness was highest in the least wealthy groups and lowest in the wealthiest groups. Frequent social participation was associated with a lower risk of loneliness and moderated the association between household wealth and loneliness, particularly among men. Compared to the wealthiest men who often took part in formal social activities, the least wealthy men who did not participate had greater risk of loneliness (OR = 1.91, 95% CI: 1.44 to 2.51). This increased risk was not observed among the least wealthy men who reported frequent participation in formal social activities (OR = 1.12, 95% CI: 0.76 to 1.67). Conclusion: Participation in external social activities may help to reduce loneliness among older adults and potentially acts as a buffer against the adverse effects of socioeconomic disadvantage

Does Social Isolation Affect Medical Doctor Visits? New Evidence Among European Older Adults

We aimed to determine whether social isolation is associated with higher health-care utilization among European older adults. We have used panel data (2004-2015) from the Survey of Health, Ageing and Retirement in Europe (SHARE) to examine the impact of social isolation on general practitioner health-care use. More precisely, we have considered negative binomial panel count data models to study the main driving factors. Socio-demographic, health, and social isolation measures are analyzed. Differences by Welfare Regimes have been also considered. Using two definitions of social isolation (Alone and Help), we have found that a sizeable proportion of those aged 50 years and older in Europe reported social isolation. Our results showed that while nonpartnership was significantly and positively correlated with health-care utilization (B = 0.03), providing help was significantly and negatively related with physician visits considering the full sample of European countries (B = -0.09). Differences by Welfare Regimes are highlighted. Also, Mediterranean countries consume more health-care services than other European ones. Targeting interventions for social isolated elders may significantly decrease general practitioner consultations and so health-care costs. Our findings provide several implications in current debates on the sustainability of welfare states