Living alone, social support, and feeling lonely among the elderly

This study aimed to describe the characteristics of the elderly population living alone, and to examine how living alone relates to feeling lonely. Interviews were conducted with a stratified random sample of 4,859 elderly individuals living in Kaohsiung, Taiwan. Variables collected included demographic information, living alone or not, activities of daily living(ADL), instrumental activities of daily living (IADL), Short Portable Mental Status Questionnaire (SPMSQ), chronic conditions, perceived social support, and a subjective measure of feeling lonely. Using logistic regression, it was found that factors associated with living alone included gender, marital status, occupation, source of income, religion, and IADL. Living alone was, in tum, related to decreased levels of both perceived social supportand feeling lonely after adjustment for potential confounders. Managing retired life is important for adult elders, particularly for men. Lack ofsocial support is common among the elderly community who live alone, which could wel1 be a main reason for this group to feel lonely. As loneliness is linked to physical and mental health problems, increasing social support and facilitating friendship should be factored into life-style management forcommunities of elderly

Influence of social support on cognitive function in the elderly

BACKGROUND: Social support is important in daily activities of the elderly. This study tests the hypothesis that there is an association between social support and cognitive function among the elderly in a community setting. METHODS: Face-to-face interviews were conducted in a cross-sectional stratified random sample of 4,993 elderly (≥65 years) city residents. Using multiple regression analysis, we investigated the influence of social support on cognitive function. RESULTS: 12% were over 80 years old. 53.28% were men. 67.14% were married. Higher Short Portable Mental Status Questionnaire (SPMSQ) scores (higher score means better cognitive function) were associated with strong social support, as measured by marital status and perceived positive support from friends. Lower cognitive function was associated with older and with female respondents. Only instrumental activities of daily living (IADL) were statistically and negatively related to SPMSQ. Lower functional status was associated with lower cognitive function. Elders with grade school educations had lower SPMSQ scores than did elders with high school educations. CONCLUSIONS: In Taiwan, higher cognitive function in community-living elderly was associated with increased social support. Life-style management should provide social activities for the elderly to promote a better quality of life

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Coping strategies and stressors in patients with hemodialysis

Objectives: To investigate the stress related to undergoing hemodialysis (HD) and the relationship between these stresses and the coping strategies used by patients with end-stage renal disease. Methods: We used the Hemodialysis Stressor Scale and the Jalowiec Coping Scale to interview 2642 patients (mean age 57 years; 53.5 % female) receiving HD. The Hemodialysis Stressor Scale measures the level of stress related to stressor subscales: daily activity, physical condition, dependency on medical staff, fluid and food restriction, role ambiguity, blood vessel problems, and reproductive system functioning. The Jalowiec Coping Scale identifies the use of the following coping strategies: problem-oriented, emotion-oriented, support seeking, avoidance, and isolated thoughts. Data were analyzed using Hierarchical Linear Modeling. Results: Daily activity subscale scores were positively associated with using emotion-oriented, avoidance, and isolated thoughts as coping styles and negatively related to support seeking from professionals. The higher the perceived stress related to physical symptoms, dependency on medical staff, and blood vessel problems, the more the patients used emotion-oriented, support seeking, avoidance, and isolated thoughts to cope. Fluid and food restriction and role ambiguity subscales were found to be positively associated with emotion-oriented, avoidance, and isolated thoughts coping strategies. Reproductive system functioning was positively associated with emotion-oriented, avoidance, and isolated thoughts coping strategies. Patients on HD seldom use problem-oriented strategy to ease their stresses. Support seeking was another infrequently used coping strategy. Conclusions: The most commonly used coping strategies in our patients were emotion-oriented, avoidance, and isolated thoughts. The choice of coping strategy depended on the types of stressor. Key words: stressor, coping, dialysis, end-stage renal disease. ESRD end-stage renal disease; HD hemodialysis; HSS Hemodialysis Stressor Scale; JCS Jalowiec Coping Scale; OLS ordinary least square

Is rehabilitation associated with change in functional status among nursing home residents?

Assessing functional status of residents in nursing homes is one way to evaluate the quality of care provided. The purpose of this study was to investigate whether rehabilitation interventions could lead to improved functional independence. A prospective study was carried out to examine the change in activities of daily living (ADL) of 310 residents aged 65 or above over a period of 6 months. About 41.3% (n = 128) received rehabilitation therapy. Functional improvement was observed in 30.6% of the participants. The corresponding figures for stabilization and functional decline were 45.2% and 24.2%, respectively. Using a multinomial logistic regression, we found that factors significantly associated with change in functional status included baseline ADL score, family visit, number of beds in the institution, and transfer to acute hospitals. After adjusting for these confounding variables, change in functional status of those who received rehabilitation and those who did not was not significantly different

The Effect of Qigong on Menopausal Symptoms and Quality of Sleep for Perimenopausal Women: A Preliminary Observational Study

[[abstract]]Objectives: The study objectives were to examine the effect of a 12-week 30-minute-a-day Ping Shuai Qigong exercise program on climacteric symptoms and sleep quality in perimenopausal women. Design: This was a prospective observational study. Settings/location: The subjects (N=70) from two communities were women aged 45 years and above who were experiencing menopausal symptoms. Subjects: Thirty-five (35) women from one community were assigned to a Ping Shuai Qigong intervention group, while 35 women from the other community were assigned to the control group. Interventions: This was a 12-week, 30-minute-a-day Ping Shuai Qigong program. Outcome measures: The Greene Climacteric Symptom scale and the Pittsburgh Sleep Quality Index were the outcome measures. Methods: Descriptive analysis and repeated-measures analysis of variance were used. Results: Pretest scores at baseline found no significant group differences in climacteric symptoms or sleep quality. Significant improvements in climacteric symptoms were found at 6 weeks and 12 weeks (t=4.07, p<0.001 and t=11.83, p<0.001) in the intervention group. They were also found to have significant improvements in sleep quality in those times (t=5.93, p<0.001 and t=10.58, p<0.001, respectively). Conclusions: Ping Shuai Qigong improved climacteric symptoms and sleep quality in perimenopausal women at 6 weeks and 12 weeks. The longer a person practiced this form of meditative exercise, the greater the improvement in sleeping quality and climacteric symptoms

Ambulatory Care Visits And Quality Of Care: Does The Volume-Control Policy Matter?

Using claims data from the Bureau of National Health Insurance (BNHI) in Taiwan and primary data collected from 940 patients who visited their physicians at out-patient clinics to complete questionnaire, we investigated the effects of the hospital volume control policy on the frequency of visits, medical expenses and patient satisfaction. We found that the volume control policy on ambulatory care decreased physician fees and increased both the number of visits and co-payments. However, it did not result in any change in the total medical expenses. A shift in ambulatory care expenditure from BNHI to patients did not improve patient satisfaction. While the patients were comfortable with the waiting line, they were not satisfied with the providers\u27 strategy of limiting quota of visits during a period of time. © 2005 Elsevier Ireland Ltd. All rights reserved

Ambulatory Care Visits And Physician Satisfaction: From Medical Directors\u27 Perspectives

BACKGROUND: Under the universal health insurance system in Taiwan, policy makers seek new approaches to balance rising costs and quality of care. One policy, Ambulatory Care Reimbursement, enacted in 2001 has effectively reduced patient numbers in clinics by cutting per patient reimbursement when a physician has seen over predetermined number of patients. PURPOSE: To access the impact of this policy on physician satisfaction in regional hospitals and medical centers (MCs) from the point of view of their medical directors. METHODOLOGY: We conducted a cross-sectional survey of medical directors from 25 MCs and 78 regional hospitals in Taiwan. The survey used a 5-point Likert scale to identify both impacts of reduced ambulatory care visits and physician satisfaction. We randomly selected 30% of all medical directors from both types of medical institutions. Of the 248 medical directors contacted, 142 replied. Excluding 5 incomplete responses, our final sample was 137. Response rates were roughly equivalent for MCs (54.67%) and regional hospitals (57.89%). FINDINGS: Medical directors were typically male, aged 45.11 years, worked in MCs (60%), and were general practitioners (43.1%). Multiple regressions associated three independent predictors of physician satisfaction: physician-patient interaction (β = .393, p = .001), mission (β = .351, p = .007), and reduced health care expenditures (β = .179, p = .014). Medical directors more often characterized the regulation of reducing number of visits as a means of encouraging MCs and regional hospitals to improve physician interaction with patients and, thus, associated it with greater patient satisfaction. Generally, directors did not believe that the regulation encouraged patients seeking care at other hospitals or that it resulted in reduced pay to physicians. PRACTICE IMPLICATION: Reducing ambulatory care visits has promoted the physician-patient relationship and allowed many physicians attain their medical mission. Such regulation had influence on the physicians\u27 satisfaction. © 2007 Lippincott Williams & Wilkins, Inc

Gender Differences In Stress And Coping Among Elderly Patients On Hemodialysis

The study investigated whether gender differences in the stressor, coping strategies, and how they associate stress and copings among 875 elderly patients undergoing hemodialysis in Taiwan. Chi-square tests, MANOVA and Structural Equation Modeling were used to attain the research purposes. The results found that the women had reported higher stress in response to physical and vessel problems and higher scores in using emotion-oriented and support-seeking coping strategies, while the men reported higher stress in reproductive system functioning and higher score in using avoidance as a coping strategy. Furthermore, the results from SEM demonstrated that after controlling for patient characteristics, no statistical difference was found between the two groups with regard to their linking of stress and coping strategies. © 2008 Springer Science+Business Media, LLC