Findings were that caregivers considered all items on the Information Needs and Patient Care Needs subscales to be important but most of the unmet needs were from the Patient Care subscale. The needs less satisfied in relation to importance were (a) ways to improve patient appearance, (b) activities that will make patient feel purposeful, (c) information on how to give medications, (d) ways to reassure patient, (e) ways of coping with patient's diagnosis, (f) ways to dress patient comfortably, (g) ways to deal with patient's decreased energy, and (h) importance of not leaving patient alone.The implications for nursing are to assess and anticipate the needs of the caregiver of the stroke survivor so that his or her needs can be met. Preparing caregivers for their new role by meeting their needs will help the nurse met the primary goal of helping the patient. / School of Physical Education

No description available.

This study investigated how patterns of in-home care utilization and predictors of service use differ for older adults based on whether they live in a rural or an urban environment and whether the service is provided from an informal, a formal, or a combination informal/formal source. The specific in-home services under consideration were: checking, continuous supervision, homemaker-household, meal preparation, nursing care, and personal care. Although the study was comparative in nature, the investigator was particularly interested in identifying patterns of service utilization that might be translated into effective and cost-efficient service delivery strategies for rural communities. The rural elderly population was the focus of this research because older people tend to live disproportionately in rural areas. Further, older rural residents seem to have more objective needs than their urban counterparts while they have access to fewer services. This study was based on data from the Statewide Survey of Older Virginians, a probability sample of 2,146 noninstitutionalized persons 60 years of age and older. The 87% response rate included 8% of the respondents who participated via an informant. A multiple regression analysis was performed for each of the eight subsamples into which the total sample was divided. The 20 independent variables were categorized according to Andersen's paradigm for conceptualizing service utilization as either predisposing, enabling, or need variables. The need variables were significant (p < .05) predictors of service use more often than the other categories, with ADL performance emerging as a significant predictor of service use across all subsamples. Evidence from existing service utilization literature formed the basis for five hypotheses included to focus the study. Results of the hypothesized relationships confirmed the generalization that this body of literature lacks the necessary precision to accurately profile rural and urban service users. Further investigation of utilization patterns of in-home care services was indicated by this research. / Ph. D.

During the past few decades much research has focused on the salutary effects of personal control over life events generally and specifically in the area of health. Studies indicate that people who feel that they are in control of the events in their lives cope more effectively than do those people who feel that their lives are governed by chance, luck, or fate. Feelings of control or mastery are an important psychological coping resource. In recent years much has been written about whether the expanding elderly population will place a burden on society because of their greater susceptibility to illness and disability, or whether life-style changes made by progressive cohorts will bring about modifications of the aging process. The question arises as to whether some sense of control over the aging process exists in a similar fashion as does control over one's health. Further, if such a sense of control over aging exists, what social structural conditions contribute to such a perceived control of aging. The present study, conducted among members of an athletic facility in a southwest Virginia city and among staff, faculty, and graduate students at a major state university, seeks to determine if a sense of control over the aging process exists, and what social structural variables and personal attributes might contribute to such a perception. Results indicate that several social structural variables (for example, gender, age and education) are predictors of perceived control over the aging process. Self-related variables (for example,self-efficacy, beliefs concerning the health benefits of exercise, and exercise behavior itself) are also significant predictors of perceived control over aging. / Master of Science

General acceptance of a pattern of activities of daily living (ADL) dependency has led to the use of an additive method of determining self-care dependency and need for long-term care. This traditional method of determining ADL levels is convenient, and it is practical to the extent that individuals in a long-term care population do fit a scaled pattern of dependency. This research was based on 3611 cases from the Preadmission Screening Program of the Virginia Medical Assistance Program. Tabular and staged logistic regression analyses examined: 1) characteristics of this group of long-term care elders, 2) the extent of ADL divergence in various recommended care settings, 3) the relationship between rehabilitation status and ADL divergence, 4) other factors influencing divergence from the ADL dependency hierarchy. The results of this study demonstrated that a large proportion of those screened did not match the original Index of ADL. Therefore, the justification for counting ADL dependency, based on an underlying hierarchy of ADL, was not upheld. Further research was indicated for improving eligibility and placement criteria that would reflect a fluid rather than a static system of long-term care. For example, rehabilitative trajectory could serve as an indicator of projected changes in assistance for self-care. / Ph. D. / incomplete_metadata

Pau, Mei Lin Margaret. / Thesis (D.Nurs.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 130-152). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese; appendixes includes Chinese.

Sze Pan Ching. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 162-178). / Abstracts in English and Chinese. / ABSTRACT --- p.i / ABSTRACT (IN CHINESE) --- p.iv / ACKNOWLEGEMENT --- p.vi / TABLE OF CONTENTS --- p.viii / LIST OF FIGURES --- p.xv / LIST OF TABLES --- p.xviii / LIST OF APPENDIX --- p.xx / LIST OF ABBREVIATIONS --- p.xxi / LIST OF DEFINITIONS OF TERMS --- p.xxii / Chapter I. --- INTRODUCTION --- p.1 / Chapter 1.1 --- Epidemiology of hip fracture among elderly worldwide --- p.1 / Chapter 1.2 --- Impact of hip fractures --- p.3 / Chapter 1.2.1 --- Mortality --- p.3 / Chapter 1.2.2 --- Hospitalization and institutionalization --- p.4 / Chapter 1.2.3 --- Morbidity --- p.4 / Chapter 1.2.4 --- Psychological impact and quality of life --- p.5 / Chapter 1.2.5 --- Financial burden --- p.6 / Chapter 1.3 --- Causes of hip fracture --- p.6 / Chapter 1.3.1 --- Mechanisms of hip fracture --- p.7 / Chapter 1.3.2 --- Degenerated protective mechanism --- p.8 / Chapter 1.3.3 --- Poor hip strength indices --- p.9 / Chapter 1.4 --- Prevention of hip fractures --- p.10 / Chapter 1.4.1 --- Reduction of the chance of lateral fall --- p.10 / Chapter 1.4.2 --- Increase hip strength indices --- p.11 / Chapter 1.4.3 --- Limitations of current strategies --- p.12 / Chapter 1.5 --- Hip protectors for prevention of hip fractures --- p.12 / Chapter 1.6 --- Effectiveness of hip protector --- p.14 / Chapter 1.6.1 --- Laboratory studies on effectiveness in force attenuation --- p.14 / Chapter 1.6.2 --- Clinical studies on prevention of hip fractures --- p.16 / Chapter 1.6.3 --- Cost-effectiveness study --- p.17 / Chapter 1.7 --- Problems on the use of hip protectors --- p.19 / Chapter 1.7.1 --- Discomfort --- p.19 / Chapter 1.7.2 --- Extra effort in wearing --- p.20 / Chapter 1.7.3 --- Appearance after wearing --- p.21 / Chapter 1.7.4 --- Urinary incontinence --- p.22 / Chapter 1.7.5 --- Oth er problems --- p.23 / Chapter 1.8 --- Acceptance and Compliance of hip protectors --- p.23 / Chapter 1.8.1 --- Acceptance --- p.23 / Chapter 1.8.2 --- Compliance --- p.24 / Chapter 1.9 --- Strategies to improve compliance of hip protector --- p.25 / Chapter 1.9.1 --- Better design of hip protector --- p.25 / Chapter 1.9.2 --- Encouragement/support to the user --- p.26 / Chapter 1.9.3 --- Support from nursing staff/carer --- p.27 / Chapter 1.10 --- Rationale and objectives of present study --- p.28 / Chapter II. --- METHODOLOGY --- p.36 / Chapter 2.1 --- Development of hip protector --- p.36 / Chapter 2.1.1 --- Design of the pads --- p.36 / Chapter 2.1.2 --- Design of the pants --- p.38 / Chapter 2.1.2.1 --- Fabric materials --- p.38 / Chapter 2.1.2.2 --- Anthropometric measurement --- p.42 / Chapter 2.1.2.3 --- Pattern design --- p.43 / Chapter 2.1.3 --- Trial use of hip protector --- p.43 / Chapter 2.1.4 --- Calculation and statistical method --- p.43 / Chapter 2.2 --- Mechanical test on force attenuation properties --- p.44 / Chapter 2.2.1 --- Testing system --- p.44 / Chapter 2.2.2 --- Simulation of impact force and identification of dropping height --- p.45 / Chapter 2.2.3 --- Testing method --- p.46 / Chapter 2.2.4 --- Calculation and statistical method --- p.47 / Chapter 2.3 --- Compliance study --- p.47 / Chapter 2.3.1 --- Setting --- p.47 / Chapter 2.3.2 --- Subjects --- p.48 / Chapter 2.3.3 --- Study design --- p.49 / Chapter 2.3.4 --- Implementation procedure and intervening Program --- p.49 / Chapter 2.3.4.1 --- Liaison with the heads and responsible staff in the elderly hostels --- p.49 / Chapter 2.3.4.2 --- Education program for hostel staff --- p.50 / Chapter 2.3.4.3 --- Education program for elderly subjects --- p.50 / Chapter 2.3.4.4 --- Fall and fracture risk counseling --- p.51 / Chapter 2.3.4.5 --- Consent and Ethical approval --- p.51 / Chapter 2.3.4.5 --- Provision of hip protector and training program on wearing hip protector --- p.51 / Chapter 2.3.4.6 --- Follow up and encouragement on the use of hip protector --- p.52 / Chapter 2.3.5 --- Outcome measures --- p.52 / Chapter 2.3.5.1 --- Primary outcome --- p.52 / Chapter 2.3.5.2 --- Secondary outcomes --- p.53 / Chapter 2.3.6 --- Measurement method --- p.55 / Chapter 2.3.6.1 --- Compliance --- p.55 / Chapter 2.3.6.2 --- Falls and fractures incidence --- p.56 / Chapter 2.3.6.3 --- Adverse effect and feedback after wearing hip protector --- p.56 / Chapter 2.3.6.4 --- Fear of fall --- p.57 / Chapter 2.3.6.5 --- Fall and fracture history --- p.57 / Chapter 2.3.6.6 --- Medical co-morbidities --- p.58 / Chapter 2.3.6.7 --- Presence of urinary incontinence --- p.58 / Chapter 2.3.6.8 --- Functional level --- p.58 / Chapter 2.3.6.9 --- Hand function --- p.58 / Chapter 2.3.6.10 --- Mobility --- p.59 / Chapter 2.3.6.11 --- Cognitive function --- p.59 / Chapter 2.3.7 --- Sample size calculation --- p.59 / Chapter 2.3.8 --- Calculation and Statistical method --- p.60 / Chapter III. --- RESULTS --- p.73 / Chapter 3.1 --- Design of hip protector --- p.73 / Chapter 3.1.1 --- The design of pants --- p.73 / Chapter 3.1.1.1 --- The fabric materials --- p.73 / Chapter 3.1.1.2 --- The size of the pants --- p.74 / Chapter 3.1.2 --- The design of pads --- p.75 / Chapter 3.1.2.1 --- Thickness of silicon padding --- p.75 / Chapter 3.1.1.2 --- Dimension of the hard shield --- p.75 / Chapter 3.2 --- Mechanical test on force attenuation properties of the pads --- p.76 / Chapter 3.2.1 --- Impact force --- p.76 / Chapter 3.2.2 --- Impact duration --- p.78 / Chapter 3.2.3 --- Selection of th e prototype --- p.78 / Chapter 3.3 --- Compliance study --- p.79 / Chapter 3.3.1 --- Demograph ics --- p.79 / Chapter 3.3.2 --- Primary outcome --- p.79 / Chapter 3.3.2.1 --- Initial acceptance rate --- p.79 / Chapter 3.3.2.2 --- Compliance rate --- p.79 / Chapter 3.3.2.3 --- Percentage of people wearing hip protector across the study period --- p.81 / Chapter 3.3.2.4 --- Percentage of protected fall --- p.81 / Chapter 3.3.3 --- Secondary outcomes --- p.81 / Chapter 3.3.3.1 --- Fall and related injury among the subjects in the study period --- p.81 / Chapter 3.3.3.2 --- Reasons for non-acceptance --- p.82 / Chapter 3.3.3.3 --- Feedback in using hip protector --- p.84 / Chapter 3.3.3.4 --- Factors associated with compliance and non-compliance (feedback in wearing hip protector) --- p.84 / Chapter 3.3.3.5 --- Factors associated with compliance and non-compliance (subject characteristics) --- p.85 / Chapter 3.3.3.6 --- Effect on mobility after wearing hip protector --- p.85 / Chapter 3.3.3.7 --- Fear of fall after wearing hip protector --- p.85 / Chapter IV. --- DISCUSSION --- p.123 / Chapter 4.1 --- Development of a hip protector for Chinese elderly --- p.124 / Chapter 4.1.1 --- Successful modifications made to the pads --- p.124 / Chapter 4.1.1.1 --- More comfort to wear with silicon cushioning materials added --- p.124 / Chapter 4.1.1.2 --- Better mechanical properties with semi-flexible plastic and silicon pad --- p.125 / Chapter 4.1.1.3 --- Smaller in dimension of the present model might improve appearance after wearing --- p.127 / Chapter 4.1.2 --- No significant improvement on compliance with modification of the pants --- p.128 / Chapter 4.2 --- Sufficient mechanical properties of hip protector demonstrated --- p.129 / Chapter 4.2.1 --- Mechanical test set up --- p.130 / Chapter 4.2.2 --- Mechanism of force attenuation --- p.132 / Chapter 4.3 --- No significant improvement on compliance shown --- p.134 / Chapter 4.4 --- Compliance at night time better than other studies --- p.136 / Chapter 4.5 --- Determinants of compliance mostly related to subjects' feedback of using hip protector rather than on their characteristics --- p.137 / Chapter 4.6 --- Better compliance observed in hostel with higher staff-to-subject ration and with occupational therapist as contact person --- p.138 / Chapter 4.7 --- Better acceptance rate of hip protector shown in the present study --- p.139 / Chapter 4.8 --- Identification of factors influencing acceptance --- p.139 / Chapter 4.9 --- Percentage of protected fall was higher than mean compliance --- p.141 / Chapter 4.10 --- No hip fracture occurred while subjects wearing hip protector --- p.141 / Chapter 4.11 --- Decreased fear of falling after wearing hip protector --- p.142 / Chapter 4.12 --- Limitation --- p.142 / Chapter 4.13 --- Recommendation --- p.143 / Chapter V. --- CONCLUSION --- p.146 / Chapter VI. --- APPENDIX --- p.148 / Chapter VII. --- BIBLIOGRAPHY --- p.162 / Chapter VIII. --- PUBLICATIONS --- p.179

This study will examine depression among the elderly in an assisted living facility. The main problem in depression in the elderly is the lack of diagnosis and treatment. Left untreated it affects the elderly person's overall well-being and may eventually lead to their mortality.

The relationship between health beliefs, based on the Health Beliefs Model, and compliance with a sodium-restricted diet was investigated. Significant predictors of compliance and the relationships among compliance measures were also investigated. The Health Beliefs Questionnaire was administered to a convenience sample of 30 hypertensive elderly subjects. Overnight urine chloride, questionnaire (added salt and salty foods), blood pressure, and dietary recall operationalized compliance. No significant relationship was found between a total health beliefs score, perceived resusceptibility to hypertension, and perceived severity of hypertension and compliance. Perceived benefits of antihypertension treatment had significant relationships with urine chloride (r = 0.41) and blood pressure (r = 0.35). Age, a significant predictor, accounted for 12% of compliance. Urine chloride significantly correlated with added salt (r = 0.44), salty foods (r = 0.44), and blood pressure (r = 0.45). Barriers to a sodium-restricted diet were categorized as no control of salt in prepared foods, desire for salt, addictive behavior, and beliefs about salt.

published_or_final_version / Community Medicine / Master / Master of Public Health