Health Promoting Behaviors, Health Needs and Associated Factors among Older Adults in Jordan: A Cross-Sectional Study

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A BSTRACT

Background:

Several factors affect older adults’ engagement in HPBs. This study aimed to examine HPBs, health needs, and associated factors among older adults in Jordan.

Methods:

A cross-sectional study was conducted on 220 older adults at one governmental and one university hospital, which were selected using convenience sampling for geographical closeness to the researchers. All older adults with no cognitive or communication problems who attended the outpatient clinics of the two hospitals from December 2018 to April 2019 were included in the study. This time period was chosen based on the convenience of the participants and researchers. Data were collected by An Arabic version of the Health-Promoting Lifestyle Profile (HPLP) and a demographic questionnaire. The Statistical Package for Social Science (SPSS) 25.0 software was used for the descriptive and inferential analysis of the study data. The level of significance was set at P<0.05.

Results:

The mean score of the total HPLP was 125.33±19.09. The marital status and educational level of the participants were associated with the total HPLP (P<0.001) in all its dimensions, except for the dimension of interpersonal relations. Participants with chronic diseases had lower scores than those without diseases for the total HPLP (P<0.001) in all the six dimensions. Family income was positively correlated with the dimensions of nutrition (P=0.007) and exercise (P=0.002).

Conclusion:

Despite the good overall mean score of older adults for total HPLP and some of its subscales, their levels of exercise and physical activity need to be promoted. The scores of older adults were related to various demographic and clinical factors.

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Most cited references 42

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Social isolation, loneliness and health in old age: a scoping review.

Emilie Courtin, Martin Knapp (2017)

The health and well-being consequences of social isolation and loneliness in old age are increasingly being recognised. The purpose of this scoping review was to take stock of the available evidence and to highlight gaps and areas for future research. We searched nine databases for empirical papers investigating the impact of social isolation and/or loneliness on a range of health outcomes in old age. Our search, conducted between July and September 2013 yielded 11,736 articles, of which 128 items from 15 countries were included in the scoping review. Papers were reviewed, with a focus on the definitions and measurements of the two concepts, associations and causal mechanisms, differences across population groups and interventions. The evidence is largely US-focused, and loneliness is more researched than social isolation. A recent trend is the investigation of the comparative effects of social isolation and loneliness. Depression and cardiovascular health are the most often researched outcomes, followed by well-being. Almost all (but two) studies found a detrimental effect of isolation or loneliness on health. However, causal links and mechanisms are difficult to demonstrate, and further investigation is warranted. We found a paucity of research focusing on at-risk sub-groups and in the area of interventions. Future research should aim to better link the evidence on the risk factors for loneliness and social isolation and the evidence on their impact on health.

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Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review

Joanna Ulley, Deborah Harrop, Ali Ali … (2019)

Background Polypharmacy, and the associated adverse drug events such as non-adherence to prescriptions, is a common problem for elderly people living with multiple comorbidities. Deprescribing, i.e. the gradual withdrawal from medications with supervision by a healthcare professional, is regarded as a means of reducing adverse effects of multiple medications including non-adherence. This systematic review examines the evidence of deprescribing as an effective strategy for improving medication adherence amongst older, community dwelling adults. Methods A mixed methods review was undertaken. Eight bibliographic database and two clinical trials registers were searched between May and December 2017. Results were double screened in accordance with pre-defined inclusion/exclusion criteria related to polypharmacy, deprescribing and adherence in older, community dwelling populations. The Mixed Methods Appraisal Tool (MMAT) was used for quality appraisal and an a priori data collection instrument was used. For the quantitative studies, a narrative synthesis approach was taken. The qualitative data was analysed using framework analysis. Findings were integrated using a mixed methods technique. The review was performed in accordance with the PRISMA reporting statement. Results A total of 22 original studies were included, of which 12 were RCTs. Deprescribing with adherence as an outcome measure was identified in randomised controlled trials (RCTs), observational and cohort studies from 13 countries between 1996 and 2017. There were 17 pharmacy-led interventions; others were led by General Practitioners (GP) and nurses. Four studies demonstrated an overall reduction in medications of which all studies corresponded with improved adherence. A total of thirteen studies reported improved adherence of which 5 were RCTs. Adherence was reported as a secondary outcome in all but one study. Conclusions There is insufficient evidence to show that deprescribing improves medication adherence. Only 13 studies (of 22) reported adherence of which only 5 were randomised controlled trials. Older people are particularly susceptible to non-adherence due to multi-morbidity associated with polypharmacy. Bio-psycho-social factors including health literacy and multi-disciplinary team interventions influence adherence. The authors recommend further study into the efficacy and outcomes of medicines management interventions. A consensus on priority outcome measurements for prescribed medications is indicated. Trial registration PROSPERO number CRD42017075315. Electronic supplementary material The online version of this article (10.1186/s12877-019-1031-4) contains supplementary material, which is available to authorized users.

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Unhealthy behaviours and disability in older adults: three-City Dijon cohort study.

F Artaud, A Dugravot, S Sabia … (2013)

To examine the individual and combined associations of unhealthy behaviours (low/intermediate physical activity, consuming fruit and vegetables less than once a day, current smoking/short term ex-smoking, never/former/heavy alcohol drinking), assessed at start of follow-up, with hazard of disability among older French adults and to assess the role of potential mediators, assessed repeatedly, of these associations. Population based cohort study. Dijon centre of Three-City study. 3982 (2410 (60.5%) women) French community dwellers aged 65 or over included during 1999-2001; participants were disability-free at baseline when health behaviours were assessed. Hierarchical indicator of disability (no, light, moderate, severe) combining data from three disability scales (mobility, instrumental activities of daily living, basic activities of daily living) assessed five times between 2001 and 2012. During the 12 year follow-up, 1236 participants (861 (69.7%) women) developed moderate or severe disability. Interval censored survival analyses (adjusted for age, sex, marital status, and education) showed low/intermediate physical activity (hazard ratio 1.72, 95% confidence interval 1.48 to 2.00), consuming fruit and vegetables less than once a day (1.24, 1.10 to 1.41), and current smoking/short term ex-smoking (1.26, 1.05 to 1.50) to be independently associated with an increased hazard of disability, whereas no robust association with alcohol consumption was found. The hazard of disability increased progressively with the number of unhealthy behaviours independently associated with disability (P<0.001); participants with three unhealthy behaviours had a 2.53 (1.86 to 3.43)-fold increased hazard of disability compared with those with none. Reverse causation bias was verified by excluding participants who developed disability in the first four years of follow-up; these analyses on 890 disability events yielded results similar to those in the main analysis. 30.5% of the association between the unhealthy behaviours score and disability was explained by body mass index, cognitive function, depressive symptoms, trauma, chronic conditions, and cardiovascular disease and its risk factors; the main contributors were chronic conditions and, to a lesser extent, depressive symptoms, trauma, and body mass index. An unhealthy lifestyle is associated with greater hazard of incident disability, and the hazard increases progressively with the number of unhealthy behaviours. Chronic conditions, depressive symptoms, trauma, and body mass index partially explained this association.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Community Based Nurs Midwifery

Journal ID (iso-abbrev): Int J Community Based Nurs Midwifery

Title: International Journal of Community Based Nursing and Midwifery

Publisher: Shiraz University of Medical Sciences (Iran )

ISSN (Print): 2322-2476

ISSN (Electronic): 2322-4835

Publication date (Print): April 2021

Volume: 9

Issue: 2

Pages: 106-116

Affiliations

[1 ] Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan

[2 ] Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan

Author notes

Corresponding author: Mohammad Rababa, PhD, CNS, CPT, RN; Jordan University of Science and Technology/School of Nursing, P O Box: 3030, Irbid, 22110 Jordan. Tel: +96 27 79511515

mjrababa@ 123456just.edu.jo

Article

Publisher ID: IJCBNM-9-2

DOI: 10.30476/ijcbnm.2020.87493.1443

PMC ID: 8053203

PubMed ID: 33875963

SO-VID: 57e186c0-a8b4-4b50-a2a5-eb9fbd684f1a

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date revision received : 30 October 2020

Date accepted : 1 November 2020

Date received : 26 August 2020

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Health Promoting Behaviors, Health Needs and Associated Factors among Older Adults in Jordan: A Cross-Sectional Study

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A BSTRACT

Background:

Methods:

Results:

Conclusion:

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Sushruta Journal of Health Policy & Opinion

Most cited references 42

Social isolation, loneliness and health in old age: a scoping review.

Deprescribing interventions and their impact on medication adherence in community-dwelling older adults with polypharmacy: a systematic review

Unhealthy behaviours and disability in older adults: three-City Dijon cohort study.

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