Disability and its effects on quality of life among older people living in Antalya city center, Turkey

Enhancing patient-centered care: Evaluating quality of life in type 2 diabetes management

AIMS

To evaluate quality of life (QoL) in patients with type 2 diabetes mellitus (T2DM).

METHODS

A cross-sectional study included 151 T2DM patients at the Clinical Centre of Montenegro. The Ferrans and Powers Quality of Life Index (QLI), validated for the Montenegrin population, assessed QoL across five domains. Participants rated items on a Likert scale from 1 (very dissatisfied) to 5 (very satisfied). Data were analysed using SPSS version 22.

RESULTS

The cohort included 51% women, with a mean age of 60.05 ±  11.63 years. Of the patients, 42% had diabetes for over a decade, and 64% had no additional health conditions. Overall, patients reported satisfactory QoL, especially in self-care and glucose management, though dissatisfaction was high regarding sexual life. Emotional support from family, housing, and friendships significantly contributed to life satisfaction, while financial concerns and job dissatisfaction were common. QoL showed no significant gender differences but declined with age and was notably lower in patients with comorbidities.

CONCLUSION

Patients with T2DM report generally satisfactory QoL, with notable concerns in socio-economic and health-related areas. Routine QoL assessments in clinical practice can improve communication, aid in early complication detection, and enable timely interventions to enhance patient outcomes.

Social Support as a Correlate of Depression and Quality of Life Among Nigerian Older Adults: a Cross-Sectional Study

Reduced social support has been associated with presence of depression and reduced quality of life among older adults. The relationships may be better understood by exploring the interactions of individual domains among the constructs. This cross-sectional survey involved a consecutive sample of 206 (116 females and 90 males) older adults living in a Southern Nigeria community. The Multidimensional Scale of Perceived Social Support, Geriatric Depression Scale, and World Health Organization Quality of Life-OLD Questionnaire, were used to measure social support, depression, and quality of life respectively. Data was analyzed using frequency counts, percentages, mean, standard deviation, multiple regression and Spearman rank-order correlation coefficient, at 0.05 alpha level. Prevalence rate of depression among participants was 45.5%. Social support was perceived to be low by 37.4% of participants with the lowest mean social support score coming from friends domain. Participants' quality of life was generally fairly good (> 60%) with the lowest scores coming from the intimacy domain. Significant correlations between social support domains and each of quality of life (p < 0.05) and depression were respectively positive and negative; but weakest for the friend and strongest for significant others domains. All quality of life domains were significantly correlated with social support except the death and dying domain. All the domains of social support (family and significant other) were significant predictors of depression except the friend domain. Significant others around individual older adults particularly those with depression ought to be educated on the importance of their roles. Stakeholders including healthcare providers may create and support programmes for improved social networking for the older adults in order to enhance their general wellbeing and quality of life.

Well-being among older persons with disabilities in Trinidad

Given the expected increase in the proportion of older persons and evidence of poverty among persons with disabilities in general, well-being among older persons with disabilities is an important issue. Using Sen's capability approach, this article examines well-being among older persons with disabilities in Trinidad. A multiphase mixed-methods design with three phases was employed. In the initial exploratory phase, functionings which are things people value doing or being were identified via 11 interviews. These functionings were used in the subsequent phase to develop an instrument with both closed- and open-ended questions. The instrument was then administered in the third phase to measure well-being and to identify its hindering factors. Responses from 31 participants revealed moderate-to-severe deprivations among older persons with disabilities in Trinidad including for functionings related to food, healthcare, information and transportation. The integrated findings suggested changes to social care and healthcare systems to promote well-being among older persons with disabilities in Trinidad, as well as the need to develop community interactions and public services regarding transportation, supportive devices, and therapy.

Psychological Wellbeing of Diabetic Individuals, Prediabetics, and Non-diabetics: A Population-Based Study in Saudi Arabia

Background

The increased burden of diabetes affects the quality of life, including psychosocial problems. The study aims to compare the psychological well-being of individuals who are prediabetic, diabetic, or non-diabetic.

Methods

A cross-sectional exploratory study was conducted from January to June 2016 (n = 1,019) in Al Kharj, Saudi Arabia. After consent and questionnaires were filled out, trained staff took blood samples followed by anthropometry. Chi-squared tests, one-way ANOVA, and multiple linear regression analyses were conducted to examine the association between diabetes classes defined by HbA1c cut-off levels set by the American Diabetes Association (three categories), individual items, and total score in general health questionnaire (GHQ). An ROC curve was plotted for the total GHQ-12 score against HbA1c.

Findings

The mean GHQ score for psychological distress was significantly higher (F = 6.569, P = 0.038) in the diabetics (mean = 14.7) and the prediabetics (12.4) than in the non-diabetics (10.71). Four out of six positive GHQ items and three out of six negative GHQ items significantly differed among the three classes of diabetes. The adjusted multivariate analysis revealed that people with diabetes were most likely to report psychological distress compared to non-diabetics (unstandardized beta = 2.414; P = 0.037). The AUC examining the relationship between HBA1c and GHQ scores showed a moderate but statistically insignificant sensitivity/specificity of 0.643 (P = 0.23).

Conclusion

This study demonstrates that psychological wellbeing is substantially poorer among diabetic or prediabetic individuals than non-diabetic individuals. Future longitudinal studies are required to examine a plausible causal relationship between diabetes/prediabetes and psychological distress.

Comparing Quality of Life of Elderly Menopause Living in Urban and Rural Areas

Objectives

The present study aimed to compare the quality of life of elderly menopause living in urban/rural areas of Abadeh, Iran.

Methods

This descriptive and cross-sectional study was conducted on 312 urban and 68 rural elderly population using the two-stage (systematic random classification) and objective-based sampling methods. Data were collected by Leiden-Padua questionnaire for assessment of quality of life in elderly menopause. SPSS software (version 21) and descriptive-analytical tests were used for data analysis.

Results

The results showed that the overall quality of life was 37.5 and 34.2 in rural and urban areas, respectively, and no statistically significant difference was observed between them. However, there was statistically significant difference in the mean score of depression and anxiety, cognitive function, social function, life satisfaction, and sexual activity in urban and rural elderly menopause (P < 0.001).

Conclusions

It seems necessary to pay more attention to the elderly menopause to improve their quality of life and consider proper planning for their empowerment and coping skills training.

Assessment of Disability and Factors Determining Disability among Inhabitants of South-Eastern Poland Aged 71-80 Years

INTRODUCTION

The aim of the study was to assess the level of disability in a sample of older people in south-eastern Poland and to identify any potential relationship between their profile of functioning and a complex set of variables including activities, participation, and contextual factors.

MATERIALS AND METHODS

The study included 800 people aged 71-80 years. The WHODAS 2.0 questionnaire was applied for the assessment of disability.

RESULTS

A total of 43.88% of the interviewees showed a moderate level of disability, while 17.75% had severe or extremely high levels of disability. In addition, 7.75% of the interviewees had no functional limitations and 30.62% demonstrated a mild level of disability. The studied individuals reported the greatest difficulties with life activities such as cleaning, cooking, or shopping, followed by Limited Participation and then getting along. Age, number of chronic diseases, a low level of education, a low level of physical activity, poor living conditions, and lack of opportunities for daily help significantly contributed to higher levels of disability.

CONCLUSIONS

Measures intended to reduce the level of disability in older adults should focus on improving medical care, health education, increasing physical activity, adapting housing to the needs of everyday functioning, and providing daily help.

Dimensions and predictors of disability-A baseline study of patients entering somatic rehabilitation in secondary care

PURPOSE

The purpose of this study was to investigate disability among patients who were accepted for admission to a Norwegian rehabilitation center and to identify predictors of disability.

MATERIALS AND METHODS

In a cross-sectional study including 967 adult participants, the World Health Organization Disability Assessment Schedule version 2.0 36-item version was used for assessing overall and domain-specific disability as outcome variables. Patients completed the Hospital Anxiety and Depression Scale (HADS), EuroQoL EQ-5D-5L and questions about multi-morbidity, smoking and perceived physical fitness. Additionally, the main health condition, sociodemographic and environmental variables obtained from referrals and public registers were used as predictor variables. Descriptive statistics and linear regression analyses were performed.

RESULTS

The mean (standard error) overall disability score was 30.0 (0.5), domain scores ranged from 11.9 to 44.7. Neurological diseases, multi-morbidity, low education, impaired physical fitness, pain, and higher HADS depressive score increased the overall disability score. A low HADS depressive score predicted a lower disability score in all domains.

CONCLUSIONS

A moderate overall disability score was found among patients accepted for admission to a rehabilitation center but "life activities" and "participation in society" had the highest domain scores. This should be taken into account when rehabilitation strategies are developed.

World Health Organization disability assessment schedule 2.0: An international systematic review

PURPOSE

This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument.

METHOD

Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on "whodas" using the ProQuest, PubMed, and Google Scholar electronic databases.

RESULTS

We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry).

CONCLUSIONS

The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single "minimal clinically important .difference" score for the WHODAS 2.0 has not yet been established.

Obesity, Apolipoprotein E ε4, and Difficulties in Activities of Daily Living Among Older Adults: a 6-Year Follow-up Study

BACKGROUND

Obesity has been associated with increased physical limitations among older adults, although few studies have adjusted for important covariates. There is limited information about the relationship between apolipoprotein E (APOE) polymorphisms and physical limitations, and the findings have been inconsistent.

PURPOSE

This study examined the longitudinal associations of obesity and APOE ε4 with difficulties in activities of daily living (ADLs) over a 6-year follow-up period controlling for multiple covariates.

METHODS

Data were analyzed from the Social Environment and Biomarkers of Aging Study (SEBAS) in Taiwan collected in 2000 and 2006, involving a cohort of 639 participants (mean age = 66). Body mass index (BMI) was used to define obesity at a baseline, and the APOE genotype was classified into an APOE ε4 carrier and non-carrier status. The combination of basic and instrumental activities of daily living (ADLs and IADLs) was used to define impaired ADLs.

RESULTS

APOE ε4 carriers had greater difficulties in combined ADLs (incident rate ratio; IRR = 1.87, 95 % CI = 1.40-2.51) than non-carriers. Obese but not overweight adults had greater difficulties in activities of daily living (IRR = 1.59, 95 % CI = 1.20-2.10) compared with the normal/underweight group. Obese older adults without APOE ε4 had greater subsequent difficulties in ADLs than non-obese non-carriers. Among APOE ε4 carriers, obesity was not a significant risk factor for the development of impaired ADLs in older adults, indicating an interaction between genotype and obesity.

CONCLUSIONS

The interaction between genotype and obesity phenotype adds new information about the determinants of physical impairment.

Assessing the quality of life in elderly people and related factors in tabriz, iran

INTRODUCTION

Elderly people may suffer from the multiple health disorders due to the vulnerability for many physical and mental disturbances. Quality of life in elderly population can be affected by many environmental factors. The aim of this study was aimed to examine the quality of life in elderly people in Tabriz, Iran in 2012.

METHODS

This cross-sectional study was carried out on 184 elderly people (male=97; female=87) with age ≥ 60 years. The participants surveyed in this study were elderly people who were living in the community and come voluntarily to the daily care centers. Validated Persian self-reported version of World Health Organization Quality of Life-BRIEF (WHOQOL-BRIEF) questionnaire including 26 broad and comprehensive questions were used to determine the quality of life in elderly people. Independent t-test and Pearson correlation were used to compare differences and correlation between the total score of quality of life and influential factors.

RESULTS

Total score the quality of life in both genders was 90.75 (13.37) (range between 26-130). Male elderly had slightly high score in the quality of life; however, these differences were not significant. A significant difference was observed between having cardiovascular diseases, respiratory and gastrointestinal diseases, hearing and visual impairments with total score in the quality of life. Also, there was no significant difference between gender and age variables with total score in the quality of life.

CONCLUSION

Policies and programs should be considered for improving the quality of life. Future studies are needed for assessing other influential factors on the quality of life in elderly population.

Assessment of Daily Activity Performance: Exploring the Option of Shortening the Test

The Assessment of Daily Activity Performance (ADAP) test has been developed to measure the physical capacity of older adults to carry out instrumental activities of daily living (ADL). The present study explores the option to create a less time-consuming short version of the ADAP that can be completed in the individual’s home environment and that imposes less of a physical burden. Data from 141 independently living women aged 70 and older were analyzed using principal components analysis (PCA). PCA identified two factors, on which 10 of the original 21 items had loaded sufficiently to be eligible for inclusion in a short version. The ADAP short version is considerably shorter than the original test and provides a good representation of the constructs being measured. More research is necessary to develop a short version of the ADAP that is easily applicable in the home environment of older adults.

Analysis of disability using WHODAS 2.0 among the middle-aged and elderly in Cinco Villas, Spain

BACKGROUND

The prevalence of disability, as defined by the International Classification of Functioning, Disability and Health (ICF), among the middle-aged and elderly population is poorly known.

OBJECTIVE

To determine disability prevalence in a resident population sample aged ≥50 years, in the Cinco Villas district, Spain, from June 2008 through June 2009.

METHODS

We used the WHODAS 2.0 36-item questionnaire to quantify the prevalence of disability, globally and by domain, together with a 13-item combined measure of three domains, Getting around, Self-care and Life activities, claimed to reflect the need of integrated services. In addition, we performed exploratory analyses of the relationship between disability and different variables using ordinal logistic regression.

RESULTS

Disability was detected by global WHODAS score in 604 of a total of 1214 persons, i.e., a prevalence of 49.8% 95% CI (46.9-52.5), with the corresponding figures for mild, moderate, severe, and extreme disability being 26.8%, 16.0%, 7.6% and 0.1%, respectively. Disability increased with age, was higher among women, and for specific domains. Prevalence of severe/extreme disability among women vs. men was as follows: Getting around, 26.8% vs. 12.1%; Life activities, 25.2% vs. 6.8%; and Self-care, 9.5% vs. 6.0%. Disability was more frequent among subjects diagnosed with dementia, chronic liver disease, severe mental disease, and stroke. The abovementioned 13-item measure yielded prevalence figures for disability levels quite similar to those obtained using 36-item scores.

CONCLUSIONS

For the first time, this study furnishes detailed disability prevalence figures and data on associated variables in a middle-aged and elderly Western population.

Relationships between social support and depression, and quality of life of the elderly in a rural community in Malaysia

INTRODUCTION

This study aimed to examine the role of social support and depression in predicting the quality of life among the elderly living in a rural Federal Land Development Authority (FELDA) community in Malaysia.

METHODS

A total of 162 elderly settlers of FELDA Sungai Tengi, aged 60 years and above, were selected by universal sampling method in this cross-sectional study. Three standardized instruments - the 12-item Short Form (SF-12), 15-item Geriatric Depression Scale (GDS-15) and Medical Outcome Study Social Support (MOS-Social Support) - were used to assess for quality of life, depression and social support.

RESULTS

Quality of life of the elderly people in this community was high, especially in terms of physical components as compared to mental components. The mean scores for emotional role in the SF-12 was relatively the highest (90.74 ± 21.59) with social functioning being the lowest (30.35 ± 22.29). The results also showed that the mean value was higher for physical component summary (74.40) as compared to mental component summary (51.51). Approximately 23.5% suffered mild depression and only 2.5% had severe depression.

DISCUSSION

This study showed that the elderly FELDA settlers have a high quality of life, mainly on the physical components of life and low rate of severe depression, a positive indicator of their psychological well-being. Social support in the form of emotional/informational support, and depression were significant factors related to their good quality of life.

Quality of Life (QOL) and Attitudes Toward Aging in Older Adults in Şanlıurfa, Turkey

Objectives: The purpose of this study was to investigate quality of life (QOL) and attitudes toward aging in older adults in a province in Turkey. Methods: This is a quantitative and descriptive study of QOL and the attitudes toward aging in older adults. Instruments: The data measurement instruments used in this study are the World Health Organization (WHO) Quality of Life Instrument–Older Adults Module (WHOQOL-OLD) and the WHO–Attitudes to Ageing Questionnaire (AAQ). Participants: The Turkish versions of the WHOQOL-OLD and AAQ were administered to 550 older adults living in şanlıurfa Province, Turkey. Results: The results indicated a significant relationship between QOL and attitudes toward aging in older adults. Two dimensions of attitudes toward aging (physical change and psychological growth) were significant predictors of QOL in older adults. It was found that gender, literacy, social security, age, and marital status affect some dimensions of QOL and some subscales of attitudes toward aging.

Prevalência de dependência em idosos e fatores de risco associados

OBJETIVO: Verificar a prevalência de dependência entre idosos assistidos por equipes da Estratégia Saúde da Família na cidade de Cuiabá (MT) e os fatores de risco associados. MÉTODOS: Estudo com delineamento transversal, tipo inquérito. A amostra estudada foi de 352 idosos com a coleta de dados realizada em seus domicílios entre os meses de junho e setembro de 2010, utilizando questionário, Índice de Katz e Escala de Lawton e Brody. RESULTADOS: A prevalência de dependência entre os idosos foi de 38,6%. A análise estatística mostrou que as características sociodemográficas e de saúde estavam associadas significativamente à dependência e ocorreram vários graus de razão de prevalência da dependência entre os idosos. CONCLUSÃO: A prevalência de dependência de 38,6% identificada entre os idosos participantes do estudo foi superior à encontrada em estudos semelhantes e sugere que essa dependência sofra influência das características sociodemográficas e de saúde apresentadas por esses idosos.

Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey

Background

Since 1986, the study of disability in Spain has been mainly addressed by National Disability Surveys (NDSs). While international attempts to frame NDS designs within the International Classification of Functioning, Disability and Health (ICF) have progressed, in general, the ICF has hardly been used in either the NDS or epidemiological studies. This study sought to identify ICF Activity- and Participation-related content in the most recent Spanish NDS, the 2008 Survey on Disabilities, Independence and Dependency Situations (Encuesta sobre discapacidades, autonomía personal y situaciones de Dependencia - EDAD 2008), and estimate the prevalence of such ICF-framed disability.

Methods

EDAD 2008 methods and questions were perused. Of the 51 EDAD items analysed, 29 were backcoded to specific d2-d7 domains of the ICF Checklist and, by rating the recorded difficulty to perform specific tasks with or without help, these were then taken as performance and capacity respectively. A global ICF score was also derived, albeit lacking data for d1, "Learning and applying knowledge", d8, "Major Life Areas" and d9, "Community, Social and Civic Life". Data were grouped by sex, age, residence and initial positive screening, and prevalence figures were calculated by disability level both for the general population, using the originally designed weights, and for the population that had screened positive to disability. Data for institutionalised persons were processed separately.

Results

Crude prevalence of ICF severe/complete and moderate disability among the community-dwelling population aged ≥6 years was 0.9%-2.2% respectively, and that of severe/complete disability among persons living in sheltered accommodation was 0.3%.

Prevalence of severe/complete disability was: higher in women than in men, 0.8% vs. 0.4%; increased with age; and was particularly high in domains such as "Domestic Life", 3.4%, "Mobility", 1.8%, and "Self-care", 1.9%, in which prevalence decreased when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group.

Conclusions

The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed.

Prevalence of disability in a composite ≥75 year-old population in Spain: a screening survey based on the International Classification of Functioning

Background

The prevalence and predictors of functional status and disability of elderly people have been studied in several European countries including Spain. However, there has been no population-based study incorporating the International Classification of Functioning, Disability and Health (ICF) framework as the basis for assessing disability. The present study reports prevalence rates for mild, moderate, and severe/extreme disability by the domains of activities and participation of the ICF.

Methods

Nine populations surveyed in previous prevalence studies contributed probabilistic and geographically defined samples in June 2005. The study sample was composed of 503 subjects aged ≥75 years. We implemented a two-phase screening design using the MMSE and the World Health Organization-Disability Assessment Schedule 2^nd edition (WHO-DAS II, 12 items) as cognitive and disability screening tools, respectively. Participants scoring within the positive range of the disability screening were administered the full WHO-DAS II (36 items; score range: 0-100) assessing the following areas: Understanding and communication, Getting along with people, Life activities, Getting around, Participation in society, and Self-care. Each disability area assessed by WHO-DAS II (36 items) was reported according to the ICF severity ranges (No problem, 0-4; Mild disability, 5-24; Moderate disability, 25-49; Severe/Extreme disability, 50-100).

Results

The age-adjusted disability prevalence figures were: 39.17 ± 2.18%, 15.31 ± 1.61%, and 10.14 ± 1.35% for mild, moderate, and severe/extreme disability, respectively. Severe and extreme disability prevalence in mobility and life activities was three times higher than the average, and highest among women. Sex variations were minimal, although life activities for women of 85 years and over had more severe/extreme disability as compared to men (OR = 5.15 95% CI 3.19-8.32).

Conclusions

Disability is highly prevalent among the Spanish elderly. Sex- and age-specific variations of disability are associated with particular disability domains.

Impact of the most frequent chronic health conditions on the quality of life among people aged >15 years in Madrid

BACKGROUND

This study sought to ascertain to what degree health-related quality of life (HRQL) in the City of Madrid was affected by each of the most frequent chronic health conditions, and the specific quality-of-life (QL) domains on which such health conditions had the greatest impact, taking co-morbidity and socio-demographic variables into account.

METHODS

A descriptive, analytical, cross-sectional study was conducted covering 7341 subjects aged >or=16 years in the City of Madrid. Data were collected on self-reported diagnosed morbidity, including hypertension, hypercholesterolaemia, varicose veins, diabetes, chronic asthma/bronchitis, myocardial infarction/angina pectoris, stomach problems, allergy, arthrosis/arthritis or rheumatism, depression/anxiety, cataracts, cerebrovascular accidents (CVACs), chronic constipation, osteoporosis and Alzheimer's disease or dementia. HRQL was measured using the COOP/WONCA questionnaire. The effects of diagnosis, age, social class, gender and the co-morbidity were analysed using a multivariate analysis of covariance (ANCOVA).

RESULTS

The chronic health conditions that registered the worst overall mean scores on the COOP/WONCA questionnaire were Alzheimer's disease or dementia, Parkinson's disease, fibromyalgia, CVACs and depression, with scores of over 26 points in all cases. After the introduction of socio-demographic variables in the model, the highest values of Snedecor's F-test corresponds to depression (F = 461.63), 'arthrosis/arthritis or rheumatism' (F = 175.41), Alzheimer's disease or dementia (F = 65.70), gastric disorders (F = 65.17), cancer (F = 43.08) and CVACs (F = 41.65).

CONCLUSIONS

Depression and 'arthrosis/arthritis or rheumatism' are the two chronic health conditions, which have the greatest impact on HRQL in Madrid's citizens, therefore is mandatory to propose and implement public health strategies that would reduce the prevalence and morbidity of such disorders.

The effect of an outdoor powered wheelchair on activity and participation in users with stroke

PURPOSE

Persons with disabilities after stroke are often restricted in activity and participation in society because of mobility limitations. An outdoor powered wheelchair may be one among other interventions in a rehabilitation programme. The aim of this study was to describe and compare activity limitations and participation restrictions in persons with stroke from their own perspective, before and after using an outdoor powered wheelchair.

METHOD

At baseline and follow-up two instruments were used: Individually Prioritized Problem Assessment (IPPA) and World Health Organization Disability Assessment Schedule II (WHODAS II).

RESULTS

The results indicated that the powered wheelchair has a great positive effect on activity and participation assessed with IPPA. The results also showed that most of the participants' problems could be categorised as belonging to the domain of 'Community, social and civic life' according to the International Classification of Functioning, Disability and Health (ICF), and the effect size in this domain was large (2.4) after the participants had used the wheelchair.

CONCLUSION

An outdoor powered wheelchair is an essential device for persons with disability after stroke with regard to overcoming activity limitations and participation restrictions in everyday life.

Assessing selected quality of life factors of nursing home residents in Turkey

As a result of improved public health and medical advances, not only has life expectancy among older people increased, but the importance of quality of life in terms of health in later life has also increased. The aim of this study was to investigate the relationship between socio-demographic factors, health-related behaviors, residents' satisfaction, and functional disability levels among elderly people living in nursing homes in Turkey using the World Health Organization's Quality of Life-BREF (WHOQOL-BREF). Data regarding socio-demographic characteristics, chronic health problems, health-related behaviors (smoking, alcohol consumption, physical activity, etc.) were collected from the study group (N=107) by a structured questionnaire during face-to-face interviews. Dependencies in activities of daily living (ADL) of the study group were also assessed using Katz's ADL index. The mean WHOQOL-BREF scores were significantly higher in participants who had independence in performing ADL (bathing, dressing, toileting, transfer, continence, feeding) (p<0.0001, p<0.0001, p<0.0001, p<0.001, p<0.0001, and p<0.001, respectively). It was found that WHOQOL-BREF scores were positively associated with having physical exercise habits and residents' satisfaction with nursing homes; being dependent in dressing were significant predictors of in the study (R(2): 0.38, p<0.003, p<0.0001, and p<0.0001, respectively). Residents' satisfaction from living nursing homes and participation in physical exercise were significant predictors of WHOQOL-BREF scores for those that participated in this study.

Validación transcultural de la Escala de Sentido de Coherencia de Antonovsky (OLQ-13) en ancianos mayores de 70 años

BACKGROUND AND OBJECTIVE

Sense of Coherence (SOC) is a construct relating to coping strategies in the face of traumatic events. SOC is defined as a personal disposition towards perceiving life experiences as understandable, manageable and meaningful. The construct has shown itself to be a predictor of self-reported and objective health in a variety of contexts. Although the SOC construct has been studied, among the elderly in particular, the scale has never been validated in the Spanish aged population. This paper reports on the cross-cultural validation of Antonovsky's Sense of Coherence Scale (OLQ-13) in a sample of Spanish senior citizens.

SUBJECTS AND METHOD

We studied a sample of population from 8 locations across Spain, totaling 419 subjects aged 70 years or over. The psychometric attributes of the scale were studied. These included acceptability, scale assumptions, internal consistency, factor structure, construct validity (convergent validity, differential analyses, inter-domains correlation), and precision.

RESULTS

The internal consistency of the scale was adequate (Cronbach = 0.80). SOC showed moderate correlations with self-reported indices of physical health, quality of life and depression. The scale was found valid in differential analyses conducted for gender, age groups, levels of disability and functional impact of diseases. Principal components analysis yielded four factors accounting for 65.59% of the variance. The Meaningfulness domain acted as an independent factor.

CONCLUSIONS

The OLQ-13 is a valid and reliable instrument for use on Spanish elderly populations, including those with low educational level.