Perception of risk of adverse outcomes of older people: comparison between nursing homes, day centers and home care services

Validity and reliability of a shorter version of the Geriatric Depression Scale in institutionalized older Portuguese adults

OBJECTIVES

Depressive symptoms are common in older adults in institutional contexts; however, there is a lack of validated measures for these settings. Identifying depressive symptoms can help clinicians to manage them and to prevent or delay their complications. This study aimed to validate the Geriatric Depression Scale (GDS) in an institutionalized sample of older adults.

METHOD

493 institutionalized older people (73% women) aged 60 or over were evaluated through the GDS, the Mini International Neuropsychiatric Interview (MINI) (depression vs. no depression = 11% vs. 89%), the Geriatric Anxiety Inventory (GAI), the Positive Affect (PA) and Negative Affect (NA) Schedule, and the Satisfaction with Life Scale (SWLS). Test-retest reliability was assessed with 57 older adults.

RESULTS

An 8-item version presented a Cronbach's alpha value of .87 with a single factor explaining its variance. The correlations (p < .01) attested the concurrent validity (GAI: r = .76; PA: r = -.22; AN: r = .62; SWLS: r = -.32). Test-retest reliability (6.51 months) was adequate (r = .52). ROC analysis (AUC = .82; sensitivity = 80%; specificity = 77%) and Youden index revealed a cutoff of 5/6 for the diagnosis of depression.

CONCLUSION

Results support the validity and the screening capacity of a short version of GDS in institutional contexts. Short screening instruments for depressive symptoms may facilitate their identification, allowing for timely clinical interventions in institutional settings.

The influence of servicescape and service credibility on older adults' intention to recover

PURPOSE

Based on the stimuli-organism-response (SOR) model and relationship marketing theory, the paper aims to examine whether servicescape influences trust, service credibility and affective commitment amongst older adults, and their effects on the intention to recover in a rehabilitation setting.

DESIGN/METHODOLOGY/APPROACH

The study takes a quantitative approach, applying confirmatory factor analysis and structural equation model to examine the responses. A total of 400 data were collected using questionnaires distributed to older adults in Malaysia. Respondents were selected based on two criteria: they should be over 65 years, and they should have been visiting the rehabilitation centres in the last 12 months.

FINDINGS

The results suggest that trust and affective commitment play significant roles in increasing the intention of older adults to recover. Contradicting previous research findings, service credibility does not have any significant impact on the intention to recover as hypothesised. The direct effect of service credibility on trust and affective commitment enhances the premise further that the relationship between service credibility and intention to recover is primarily indirect. Even though we expect servicescape to be a significant driver in forming the behaviour of older adults, its impact on intention to recover, trust and affective commitment remain non-significant, with the exception of service credibility.

ORIGINALITY/VALUE

Past studies have focused on the roles of servicescape and service credibility separately. We have extended the literature by examining the combined effects of both servicescape and service credibility. The findings, therefore, contribute to a deeper understanding of the literature on the intention-behaviour relationship in the context of healthcare, as well as in service marketing.

Frailty as the Future Core Business of Public Health: Report of the Activities of the A3 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA)

Background: The prevalence of frailty at population-level is expected to increase in Europe, changing the focus of Public Health. Here, we report on the activities of the A3 Action Group, focusing on managing frailty and supporting healthy ageing at community level. Methods: A three-phased search strategy was used to select papers published between January 2016 and May 2018. In the third phase, the first manuscript draft was sent to all A3-Action Group members who were invited to suggest additional contributions to be included in the narrative review process. Results: A total of 56 papers were included in this report. The A3 Action Group developed three multidimensional tools predicting short–medium term adverse outcomes. Multiple factors were highlighted by the group as useful for healthcare planning: malnutrition, polypharmacy, impairment of physical function and social isolation were targeted to mitigate frailty and its consequences. Studies focused on the management of frailty highlighted that tailored interventions can improve physical performance and reduce adverse outcomes. Conclusions: This review shows the importance of taking a multifaceted approach when addressing frailty at community level. From a Public Health perspective, it is vital to identify factors that contribute to successful health and social care interventions and to the health systems sustainability.