Supportive exchange: an exploration of the relationship between social contacts and perceived health status in the elderly

The Impact of a Home-Delivered Meal Program on Nutritional Risk, Dietary Intake, Food Security, Loneliness, and Social Well-Being

Maintaining independence and continuing to live at home is one solution to manage the rising health care costs of aging populations in the United States; furthermore, seniors are at risk of malnutrition and food insecurity. Home-delivered meal programs are a tool to address food, nutrition, and well-being concerns of this population. Few studies have identified outcomes from these programs; this pilot study reviews the nutritional status, dietary intake, well-being, loneliness, and food security levels of seniors participating in a Meals on Wheels delivery service. Clients, new to the meal program, participated in pre- and postphone interviews, and 51 seniors completed the study. The survey was composed of five scales or questionnaires, and statistical analyses were conducted using SPSS. Improvements across all five measures were statistically significant after participating two months in the home-delivered meal program. Implications for further research, practice, and the Older Americans Act are discussed.

Soutien conjugal, stratégies adaptatives et bien-être: analyse différentielle des perceptions des conjoints âgés

The purpose of this study was to describe the elderly marital partners' perceptions of conjugal support and coping strategies and the relationship between these perceptions and their well-being. A multistage sample of 135 community-dwelling elderly couples, 65 years of age and over, was drawn from users and non-users of the health and social systems in a large metropolitan area. A series of questionnaires, presented within an interview format, were used to measure the variables. Each spouse was separately interviewed at home. Pairedt-tests revealed that husbands tended to perceive more support from their spouse and to use less external social support than wives when coping with daily problems. Intraclass coefficients of correlation between husbands' and wives' coping strategies were only low to moderate. However, for both marital partners, results revealed significant positive correlations between availability and reciprocity of conjugal support and well-being and a negative association between conflict within the conjugal relationship and well-being. Only two cognitive coping strategies, namely reframing and active appraisal were positively related to the well-being of both spouses. Repeated measures analysis of variance revealed that congruency of perception between husbands and wives had an effect only on wives' well-being. These findings suggest psychosocial interventions and are discussed in relation to previous studies and future research.

Psychosocial correlates of nutritional risk in older adults

The psychosocial correlates of nutritional risk among older adults were examined in a study involving 54 people over age 65 (range, 65 to 98; average, 81), who were selected through a convenience sampling strategy. Measures included a background questionnaire, Mini Nutritional Assessment, Life Satisfaction Index Form Z, Geriatric Depression Scale, and Lubben's Social Network Scale. Seventeen percent of participants were found to be at risk of malnutrition. Compared with those who had adequate nutrition, at-risk participants had lower levels of social support (approaching statistical significance, p=0.08) and life satisfaction (not significant), and significantly higher levels of depression (p=0.04). Hierarchical multiple regression analysis showed that depression and social support were significant correlates of nutritional risk (p=0.01). Nutrition professionals should have a multidisciplinary perspective when they assess older adults' nutritional status.

The conceptual and empirical link between health behaviors, self reported health, and the use of home health care in later life

The primary qualification for Medicare's home health care benefit is being homebound, typically by a chronic disability. Disability and functional ability in late-life are heavily influenced by the long-term practice of health behaviors. One of the goals of Healthy People 2000 is to increase the years of healthy life which are measured, in part, by self reported health status. This compression of morbidity would, in effect, reduce the need for long term care. This paper examines three conceptual models linking health behaviors to self reported health in a unique sample of older adults who have chosen to participate in a corporate sponsored wellness program. It is hoped that these findings will encourage further research on formulating empirical pathways from health behaviors to reduced need for home health care.

Health and social support among older women in congregate housing

This study of community-dwelling elderly women found that perceptions of positive health status and adequate social support do not decline with age, even among the old old. The relationship between health status and social support reflects the reciprocal nature of person and environment found in the ecologic model.

Social support. Among elderly in two community programs

Elderly individuals lacking adequate social support have shown greater deficits and difficulties in illness recovery, length of hospitalization, and development of cognitive and emotional changes than those who do receive adequate social support. This study evidenced a very meaningful finding for nurses--older adults who are often dependent upon others for support in some or most facets of daily living specified love and respect as the type of support most needed, rather than tangible aid. In most communities, a wide array of educational and support group programs are offered to older adults. Social networking and the enhancement of social support among participants should be primary goals of such programs.

Social ties and health status: an examination of moderating factors

The goals of the study are to assess the relationship between social ties and health status and to determine if factors that may inhibit or enhance the mobilization of resources available in social ties specify this relationship. Two factors which may influence the effective use of social network resources perceived control and trusting others, are examined as possible moderating factors. The study population includes 2,603 adults, who were randomly selected from among the enrollees of a large health maintenance organization. The subjects were part of a large household interview survey. Medical record data covering seven years of outpatient services were linked with the survey data on the respondents. The findings indicate that having more social ties, being more trustful of others and perceiving more control are all related to having better health. Perceived control does specify the relationship between social ties and health status. The findings suggest that a larger social network is more important for those less able to utilize the resources available in their networks effectively, while among those more able to mobilize support from their networks, size is less important. The implications for health education research and practice are discussed.

Coping with serious illness: on integrating constructs to enhance clinical research, assessment and intervention

Empirical research suggests that given relatively similar illness contingencies, patients who cope successfully with serious illness have access to and use effectively social network support, believe events are to some extent within their control, perceive themselves to be effective, and employ an array of flexible coping strategies. Based on a selective literature review, the argument is made that more integrative conceptual frameworks are needed to advance theory and to enhance the applied value of research data. Clinical implications for assessment, intervention, and evaluation are set forth.

The relationship of two dimensions of social support to the psychological well-being and social functioning of women with advanced breast cancer

Of interest to the field is the mechanism through which social support acts as a resistance resource for individuals undergoing stressful life circumstances. Women with advanced breast cancer (N = 86) were interviewed to determine how their outlook on life and social functioning were affected by the social support they received. Emotional support provided by the family was predicted to affect the woman's sense of well-being whereas the opportunities for social exchange provided by one's social activities were expected to effect the woman's social functioning. Consistent with the predictions, the data indicate that social support is multidimensional. Emotional support was strongly related to one's outlook. However, one's opportunities for social exchange affect not only one's social functioning, but also one's outlook on life, suggesting an interactive process whereby family support improves outlook, both outlook and opportunities for social exchange are related to one's sense of social functioning. These data explain the erosion of social support during life-threatening illness such as cancer as a result of the limitations imposed by the illness on one's opportunities for social exchange.