Self-rated health (SRH) is a widely used indicator of general health and multiple studies have supported the predictive validity of SRH in older populations concerning future health, functional decline, disability, and mortality. The aim of this study was to use the theoretical framework of the International Classification of Functioning, Disability and Health (ICF) to create a better understanding of factors associated with SRH among community-dwelling older people in urban and rural areas.
The study design was population-based and cross-sectional. Participants were 185 Icelanders, randomly selected from a national registry, community-dwelling, 65-88 years old, 63% urban residents, and 52% men. Participants were asked: "In general, would you say your health is excellent, very good, good, fair, or poor?" Associations with SRH were analyzed with ordinal logistic regression. Explanatory variables represented aspects of body functions, activities, participation, environmental factors and personal factors components of the ICF.
Univariate analysis revealed that SRH was significantly associated with all analyzed ICF components through 16 out of 18 explanatory variables. Multivariate analysis, however, demonstrated that SRH had an independent association with five variables representing ICF body functions, activities, and personal factors components: The likelihood of a better SRH increased with advanced lower extremity capacity (adjusted odds ratio [adjOR] = 1.05, p
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Cites: J Gerontol A Biol Sci Med Sci. 2002 Apr;57(4):M209-1611909885
Older people are being encouraged to be physically active for as long as possible as a preventive measure against disease and functional decline. It remains, however, uncertain how living in a retirement community affects physical activity (PA).
This study was conducted to understand the PA experiences of older women living in retirement communities and what they experience as facilitators of and barriers to PA.
The study was qualitative and guided by the Vancouver School of doing phenomenology, a unique blend of phenomenology, hermeneutics, and constructivism.
Participants were 10 women, aged from 72 to 97 years (mean=84 years). In-depth interviews were conducted, recorded, transcribed, and thematically analyzed.
A model was constructed with 3 main themes: (1) the women themselves, including their experienced health condition, individual aspects of functioning, and various personal factors; (2) the physical environment; and (3) the social environment. These main themes all include subthemes of experienced influences on PA, such as health, design of housing and environment, and local culture. These influences could both facilitate and hinder PA, depending on the context. The facilitating effects of good outdoor areas, accessible physical training facilities, a familiar neighborhood, and finding joy in PA were clear in the study. The barriers included worsening health, a colder climate with ice and wind, and lack of a PA culture within the retirement community.
An older woman's residence may strongly influence her ability and motivation to be physically active. Physical therapists should acquaint themselves with the facilitators of and barriers to PA of women within retirement communities and use that knowledge to influence the physical and social environment and to target PA interventions to the women themselves.
A positive attitude toward evidence-based practice (EBP) has been identified as an important factor in the effectiveness of the dissemination and implementation of EBP in real-world settings.
The objectives of this study were: (1) to describe dimensions of Icelandic physical therapists' attitudes toward the adoption of new knowledge and EBP and (2) to explore the association between attitudes and selected personal and environmental factors.
This study was a cross-sectional, Web-based survey of the total population of full members of the Icelandic Physiotherapy Association.
The Evidence-Based Practice Attitude Scale (EBPAS) was used to survey attitudes toward EBP; the total EBPAS and its 4 subscales (requirements, appeal, openness, and divergence) were included. Linear regression was used to explore the association between the EBPAS and selected background variables.
The response rate was 39.5% (N=211). The total EBPAS and all of its subscales reflected physical therapists' positive attitudes toward the adoption of new knowledge and EBP. Multivariable analysis revealed that being a woman was associated with more positive attitudes, as measured by the total EBPAS and the requirements, openness, and divergence subscales. Physical therapists with postprofessional education were more positive, as measured by the EBPAS openness subscale, and those working with at least 10 other physical therapists demonstrated more positive attitudes on the total EBPAS and the openness subscale.
Because this was a cross-sectional survey, no causal inferences can be made, and there may have been unmeasured confounding factors. Potential nonresponse bias limits generalizability.
The results expand understanding of the phenomenon of attitudes toward EBP. They reveal potentially modifiable dimensions of attitudes and the associated characteristics of physical therapists and their work environments. The findings encourage investigation of the effectiveness of strategies aimed at influencing various dimensions of attitudes toward EBP.
To study how selected indicators of socioeconomic status and urban-rural residency associate with medication use in form of number of daily medications, polypharmacy, and medication use according to Anatomic Therapeutic Classification (ATC) system.
Cross-sectional, population-based study among older community-dwelling Icelanders. Criteria for participation were: age =65 years, community-dwelling, and able to communicate verbally and to set up a time for a face-to-face interview. Information on medication use was obtained by interviews and by examining each person's medication record. Medications were categorised according to ATC system. A questionnaire and the physical and mental health summary scales of SF-36 Health Survey were used to assess potential influential factors associated with medication use.
On average, participants (n=186) used 3.9 medications, and the prevalence of polypharmacy was 41%. No indicators of socioeconomic status had significant association to any aspects of medication use. Compared to urban residents, rural residents had more diagnosed diseases, were less likely to live alone, were less likely to report having adequate income, and had fewer years of education. Controlling for these differences, urban people were more likely to use medication from the B and C categories. Moreover, older urban men, with worse physical health, and greater number of diagnosed diseases used more medications from the B category.
There are unexplained regional differences in medications use, from categories B and C, by older Icelanders. Further studies are needed on why urban residents used equal number of medications, or even more medications, compared to rural residents, despite better socioeconomic status and fewer diagnosed diseases.