Determinants of social participation of visually impaired older adults

PURPOSE: To assess determinants of social participation among visually impaired older adults. METHODS: This cross-sectional study included visually impaired persons (>/=55 years; n = 173) who were referred to a low-vision rehabilitation center. Determinants (i.e., sociodemographic, physical, social and psychological factors, and personal values) of participation were identified in four domains of participation: (1) domestic life; (2) interpersonal interactions and relationships; (3) major life areas; and (4) community, social, and civic life. Study participants completed telephone interviews. RESULTS: Age, physical fitness, and helplessness were determinants of participation in domestic life. Social network size was associated with participation in major life areas. The personal value attached to participation (i.e., perceived importance) was a determinant of participation in interpersonal interactions and relationships, major life areas, and community, social and civic life. Vision-related characteristics (i.e., self-perceived vision and degree of visual impairment) were not associated with participation. CONCLUSIONS: Across the participation domains, perceived importance is a major determinant of social participation among visually impaired older adults. Physical health along with social and psychological status, also affect participation. Knowing how participation is determined can be used to develop rehabilitation interventions to enhance participation of visually impaired older adults

The Effects of Neighbourhoods on Size of Social Network of the Elderly and Loneliness: A Multilevel Approach

Our goal was to find out how much influence neighbourhoods have on the size of the social network and loneliness of elderly people. The results show that the average size of the social network was 9, while the elderly had few feelings of loneliness. Neighbourhoods could at most explain 8 per cent of the size of social network and 6 per cent of loneliness. It is concluded that the elderly mostly have substantially sized social networks and few feelings of loneliness. Social networks and loneliness are probably more strongly related to the (psychological or social) characteristics of individuals and are hardly influenced by the characteristics of neighbourhoods.

Psychometric properties of the RAND-36 among three chronic disease (multiple sclerosis, rheumatic diseases and COPD) in the Netherlands

Objective: In this article, psychometric properties both of the total RAND-36 and of its subscales, such as unidimensionality, differential item functioning (DIF or item bias), homogeneity and reliabilities, are examined. Methods: The data from populations with three chronic illnesses, multiple sclerosis (n = 448), rheumatism (n = 336) and COPD (n = 259), have been collected in different parts of the Netherlands. The main technique used was Mokken scale analysis for polytomous items. Results: All subscales of the RAND-36 appeared to be unidimensional. For the sub scales 'mental health' and 'general health perceptions' some minor indications of DIF for the different chronic illnesses were found. Reliabilities of almost all subscales in all subpopulations were higher than 0.80, while the homogeneities of almost all subscales in all subpopulations were higher than 0.50, indicating 'strong unidimensional, hierarchical scales'. Conclusions: In general, the subscales of the RAND-36 can be used to compare persons with different chronic illnesses. The subscale 'general health perceptions' did not function as well as would be preferred

Predictors of functional disability in rheumatoid arthritis: Results from a 13-year prospective study

Purpose. To explore the role of distress and social support as modifiers of functional disability in rheumatoid arthritis (RA). We hypothesized that: (a) higher inflammatory activity, more joint tenderness and more pain lead to more disability, and (b) that more distress and less social support lead to more disability and accelerate the disablement process by moderating the effects of inflammatory activity, joint tenderness and pain. Methods. The study is a Dutch extension of the European Research on Incapacitating Diseases and Social Support (EURIDISS) which started with 292 patients. After five waves of data collection 129 still participated. Correlational and hierarchical regression analyses were performed. Results. In short-term RA, 68% of the variance in disability could be explained primarily by mean disability over the prior years. Other important predictors were inflammatory activity and pain. In long-term RA, 56% of the variance in disability could be explained primarily by mean disability over the prior years. Other important predictors were joint tenderness and pain. No clear moderator effects of distress and social support were found in short-term or longterm RA. Conclusions. The results confirm the main pathway from pathology to disability in short-term and long-term RA, but do not provide support for the influence of distress and social support on the disablement process.

The differential effects of rheumatoid arthritis on distress among patients and partners

This study investigated primary and secondary stressors of distress in rheumatoid arthritis patients and partners, analysing data of 61 couples. Patients' disability was found to be a primary stressor of their distress. In addition, it also had an indirect effect on partners' distress through partners' primary stressor, perceived burden. Marital quality and negative transactions can be considered joint secondary stressors for partners, not for patients. An indication of an indirect effect of marital quality on patients' distress was found, through partners' burden. Using a multilevel model, which takes into account the dependence between patients' and partners' distress, 36% of the variance in patients' distress could be explained, whereas 68% of partners' distress variance was explained. More knowledge on how patient and partner influence each other's distress is needed to develop psychosocial interventions that will help patients and partners minimize their psychological distress and prevent deterioration of their marital quality

The differential effects of rheumatoid arthritis on distress among patients and partners

This study investigated primary and secondary stressors of distress in rheumatoid arthritis patients and partners, analysing data of 61 couples. Patients’ disability was found to be a primary stressor of their distress. In addition, it also had an indirect effect on partners’ distress through partners’ primary stressor, perceived burden. Marital quality and negative transactions can be considered joint secondary stressors for partners, not for patients. An indication of an indirect effect of marital quality on patients’ distress was found, through partners’ burden. Using a multilevel model, which takes into account the dependence between patients’ and partners’ distress, 36% of the variance in patients’ distress could be explained, whereas 68% of partners’ distress variance was explained. More knowledge on how patient and partner influence each other’s distress is needed to develop psychosocial interventions that will help patients and partners minimize their psychological distress and prevent deterioration of their marital quality.

Amputation, phantom pain and subjective well-being:a qualitative study

The purpose of this qualitative study was to explore the impact of an amputation and of phantom pain on the subjective well-being of amputees. Sixteen lower-limb amputees were interviewed. A semi-structured interview and two Visual Analogue Scales were used. To interpret the results, a new socio-medical model joining two models, 'The Disablement Process model' and the 'Social Production Function theory', was used. Questions were asked concerning the factors influencing patients' subjective well-being prior to, at the time of and after an amputation. These factors were patients' medical history, their phantom sensations and phantom pain, their daily activities, the social support they received, and the influence of an amputation and phantom pain on long-term behaviour and on their subjective well-being. All factors were found to have an influence on the individual's subjective well-being. All these factors, however, seemed to reinforce each other. Therefore, the greatest influence of factors on subjective well-being occurred when more than one factor was involved. Substituting certain activities by others then becomes less and less effective in inducing a sense of subjective well-being

Psychosocial dysfunction in the first year after Guillain–Barré syndrome

In this investigation we study the impact of Guillain Barre syndrome (GBS) on psychological distress, depressive symptoms, and health status of patients during the first year after GBS. At 3, 6, and 12 months, patients were given the General Health Questionnaire, the Sickness Impact Profile, and the Center for Epidemiologic Studies Depression Scale. Eighty-five patients participated. Psychological distress and depressive symptoms were present but improved between 3 and 6 months. At 12 months the psychosocial health status was still impaired. Patients who perceived their physical residua to be moderately to seriously disruptive and patients with muscle ache and cramps had worse scores on all scales. It can be concluded that most of the improvement occurred in the first 6 months. Psychosocial health status, however, was still impaired at 1 year, but depressive symptoms played no role. Treatment of muscle ache and cramps, and the disruptive effect of physical residua should be seriously considered. Muscle Nerve 41: 533-539, 201