48 research outputs found

    Profiles of physical activity biographies in relation to life and aging satisfaction in older adults: longitudinal findings

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    Background: While there is substantial evidence on the relationship between life satisfaction and present physical activity (PA), less is known about which specific PA biographies are associated with a high quality of life and aging satisfaction. Our objective was to identify classes of PA biographies that may be associated with life and aging satisfaction. Methods: In this longitudinal study, PA biographies were assessed retrospectively as a baseline, followed by assessments of life and aging satisfaction at six and twelve months in 418 adults aged 60‚Äď95. Subgroups with different PA biographies were identified using latent class analysis. Results: Four distinct PA biographies emerged: increasingly active (35%; n = 147); consistently active (25%; n = 103); consistently inactive (18%; n = 75); and decreasingly active (22%; n = 94). Being consistently active was related to life satisfaction (ő≤ = .17) and consistent inactivity was associated with aging dissatisfaction (ő≤ = ‚ąí.20) when accounting for current PA levels. Conclusions: In addition to current PA, our findings emphasize the value of PA biographies for life and aging satisfaction, which could inform lifespan theories of PA and health promotion

    Informal caregivers during the COVID-19 pandemic perceive additional burden: findings from an ad-hoc survey in Germany

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    Background: While the relation between care involvement of informal caregivers and caregiver burden is well-known, the additional psychosocial burden related to care involvement during the COVID-19 pandemic has not yet been investigated. Methods: A total of 1000 informal caregivers, recruited offline, participated in a cross-sectional online survey from April 21 to May 2, 2020. Questionnaires were used to assess COVID-19-specific changes in the care situation, negative feelings in the care situation, problems with implementation of COVID-19 measures, concerns/excessive demands, loss of support, change in informal caregivers' own involvement in care and problems with provision, comprehension & practicability of COVID-19 information, and to relate these issues to five indicators of care involvement (i.e., being the main caregiver, high expenditure of time, high level of care, dementia, no professional help). Binomial and multiple regression analyses were applied. Results: Across indicators of care involvement, 25.5-39.7% reported that the care situation rather or greatly worsened during the COVID-19 pandemic, especially for those caring for someone with dementia or those usually relying on professional help. In a multiple regression model, the mean number of involvement indicators met was associated with age (beta = .18; CI .10-.25), excessive demands (beta = .10, CI .00-.19), problems with implementation of COVID-19 measures (beta = .11, CI .04-.19), an increase in caregiving by the informal caregivers themselves (beta = .14, CI .03-.24) as well as with no change in the amount of caregiving (beta = .18, CI .07-.29) and loss of support (beta = -.08, CI -.16-.00). No significant associations with the mean number of involvement indicators met were found for gender, educational level, change in the care situation, negative feelings, and provision, comprehension & practicability of COVID-19 information. Conclusion: Those caregivers who perceived extensive care burden were those who suffered most during the pandemic, calling for structural support by the healthcare system now and in the future

    I’m curious, I’m open to it, I test it, I trust it! A focus groups study to understand a-priori trust in automated buses

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    Trust is regarded as one of the main predictors for adopting automated buses (ABs). However, theories about trust (development) in technology generally vary and an in-depths study about trust in ABs specifically is still outstanding. The present study fills this gap by presenting results from focus group interviews to trust (development) in shared automated buses prior to exposure. The objectives of this study are to contrast participants‚Äô na√Įve concepts of trust with theory and to identify underlying factors influencing a-priori trust in ABs. Results show that the N = 21 focus group participants use different strategies to familiarise themselves with the new technology of ABs, e.g., comparisons with familiar technologies, fundamental tendencies to approach or avoid, additional information seeking, or anthropomorphisation. These strategies largely support existing theories on trust (development) in technology. Differences between na√Įve interpretations of trust and its theoretical assumptions were found in focus group debates where more control over technology limited uncertainty and led to more trust. While theories suggest control and trust to be incompatible opposites, participants see control as a way to enhance trust. We provide starting points for further theory development and expansion and stress the importance of explanations in emerging technologies for trust and acceptance building

    Outpatient psychotherapy for home-living vulnerable older adults with depression: study protocol of the PSY-CARE trial

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    Background: There is a need to improve psychotherapeutic approaches to treatment for vulnerable older adults with depression in terms of both clinical practice and health care supply. Against this background, PSY-CARE is testing the feasibility and effectiveness of outpatient psychotherapy for home-living older adults in need of care with depression in Berlin, Germany, and neighboring suburban areas. Methods: In a two-arm single-center pragmatic randomized controlled trial (RCT), manual-guided outpatient psychotherapy will be compared to brief psychosocial counseling. The study population will be compromised of older adults with clinically significant depressive symptoms who have a long-term care grade, as assessed by the German compulsory state nursing care insurance. In the intervention group, individual cognitive-behavioral psychotherapy tailored to the specific needs of this population will be offered by residential psychotherapists as part of the regular healthcare service. In the active control group, participants will receive individual psychosocial telephone counselling and a self-help guide. The planned sample size is N‚ÄČ=‚ÄČ130 (n‚ÄČ=‚ÄČ65 participants per group). The reduction of depressive symptoms (primary outcome) as well as the maintaining of activities of daily living, quality of life, and functioning will be assessed with questionnaires provided at baseline, after the end of the intervention and after three months. Feasibility and process evaluation will be conducted qualitatively based on documentation and interviews with psychotherapists, gatekeepers and the participants. Discussion: PSY-CARE investigates the potentials and limitations of providing outpatient psychotherapeutic treatment meeting the demands of vulnerable home-living older adults with depression under the real conditions of the health care system. The study will provide practical implications to improve access to and quality of outpatient psychotherapy for this poorly supplied population. Trial registration: The trial is registered at ISRCTN55646265; February 15, 2019

    Quality of life in people with dementia living in nursing homes: validation of an eight-item version of the QUALIDEM for intensive longitudinal assessment

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    Purpose: Our aim was to examine whether quality of life which was repeatedly assessed over time is related with the comprehensive assessment of quality of life (QoL) and thereby to validate a brief QoL assessment. Method: This longitudinal study used a comprehensive assessment of quality of life at baseline (QUALIDEM; 37 items) to validate an eight-item version of QUALIDEM to assess momentary quality of life which was repeatedly administered using a tablet device after baseline. In all, 150 people with dementia from 10 long-term facilities participated. Momentary quality of life and comprehensive quality of life, age, gender, activities of daily living (Barthel Index), Functional assessment staging (FAST), and Geriatric Depression (GDS) have been assessed. Results: Comprehensive and momentary quality of life showed good internal consistency with Cronbach‚Äôs alpha of .86 and .88 to .93, respectively. For multiple associations of momentary quality of life with the comprehensive quality of life, momentary quality of life was significantly related to comprehensive quality of life (B‚ÄČ=‚ÄČ.14, CI .08/.20) and GDS (B‚ÄČ=‚ÄČ‚ąí‚ÄČ.13, CI ‚ąí‚ÄČ.19/‚ąí‚ÄČ.06). More specifically, the comprehensive QUALIDEM subscales ‚Äėpositive affect‚Äô, ‚Äėnegative affect‚Äô, ‚Äėrestlessness‚Äô, and ‚Äėsocial relationships‚Äô showed significant positive associations with momentary quality of life (p‚ÄČ<‚ÄČ.001). Conclusion: We found that momentary quality of life, reliably assessed by tablet, was associated with comprehensive measures of quality of life and depressive symptoms in people with dementia. Broader use of tablet-based assessments within frequent QoL measurements may enhance time management of nursing staff and may improve the care quality and communication between staff and people with dementia

    Is there an association between social determinants and care dependency risk? A multi‚Äźstate model analysis of a longitudinal study

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    Despite a growing body of knowledge about the morbidities and functional impairment that frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was to examine the effect of social determinants on care dependency onset and progression. We used data from the Berlin Initiative Study, a prospective, population-based cohort study including 2,069 older participants living in Berlin. Care dependency was defined as requiring substantial assistance in at least two activities of daily living for 90 min daily (level 1) or 3+ hours daily (level 2). Multi-state time to event regression modeling was used to estimate the effects of social determinants (partnership status, education, income, and sex), morbidities, and health behaviors, characteristics, and conditions. During the study period, 556 participants (27.5%) changed their status of care dependency. Participants without a partner at baseline were at a higher risk to become care-dependent than participants with a partner (hazard ratio [HR], 95% confidence interval [CI]: 1.24 (1.02-1.51)). After adjustment for other social determinants, morbidities and health behaviors, characteristics, and conditions the risk decreased to a HR of 1.19 (95% CI: 0.79-1.79). Results indicate that older people without a partner may tend to be at higher risk of care dependency onset but not at higher risk of care dependency progression. Clinicians should inquire about and consider patients' partnership status as they evaluate care needs