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      Stereotypes about very old people and perceived societal appreciation in very old age Translated title: Stereotype über hochaltrige Menschen und empfundene gesellschaftliche Wertschätzung in der Hochaltrigkeit

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          Abstract

          Background

          People in very old age (VOA) are expected to be confronted with particularly negative stereotypes. These influence societally shared behavior towards and judgements about them. Such external evaluations of individuals’ lives are considered a crucial part of their quality of life (QoL).

          Objective

          The present study elaborated a) the societal appreciation perceived by people in VOA and b) the stereotypes about people in VOA held by stakeholders from key societal areas. The aim was to discuss possible connections between these external standards and individual life results.

          Material and methods

          A parallel mixed methods design was employed. Cross-sectional data from a representative survey of people aged 80 years and older ( n = 1863) were analyzed by means of χ 2-tests and Kruskal-Wallis tests to examine differences in perceived societal appreciation (PSA) by characteristics of the person, their biography, and current lifestyle. Linear regression models were used to investigate the impact of these characteristics on PSA. Regarding stereotypes about people in VOA, semi-structured interviews with stakeholders from key societal areas ( n = 22) were analyzed using qualitative content analysis. The quantitative and qualitative findings were juxtaposed for comparison.

          Results

          PSA was predicted by health-related variables and productive activities. Several societal stakeholders highlighted that age-related losses pose challenges on very old individuals, their families, and society, whereas remaining potentials in VOA can and should be used for the benefit of others; however, stakeholders‘ perceptions differed by the extent of their professional contact with (very) old people. Different pathways were proposed through which the observed stereotypes and determinants of PSA might be connected (e.g., stereotype internalization).

          Conclusion

          Our study illustrates the relevance of external standards for individual QoL and highlights the need for a normative perspective in the discussion about QoL and its enhancement.

          Supplementary Information

          The online version of this article (10.1007/s00391-021-01971-y) contains supplementary material, which is available to authorized users. The article and the supplementary material are available in the electronic full-text archive at https://www.springermedizin.de/zeitschrift-fuer-gerontologie-und-geriatrie. You will find the supplementary material at the end of the article.

          Translated abstract

          Hintergrund

          Stereotype über hochaltrige Menschen gelten als besonders negativ. Sie beeinflussen das gesellschaftlich geteilte Verhalten Hochaltrigen (HA) gegenüber und Urteile über diese. Solche externen Bewertungen stellen einen wichtigen Teil individueller Lebensqualität dar.

          Ziele der Arbeit

          Die Studie untersuchte a) die von HA empfundene gesellschaftliche Wertschätzung (EGW) und b) die Stereotype über HA von Vertretern zentraler Gesellschaftsbereiche. Ziel war es, mögliche Verbindungen zwischen diesen externalen Standards und individuellen Lebensqualitätsresultaten (LQR) zu diskutieren.

          Material und Methoden

          Es wurde ein paralleler Mixed-Methods-Ansatz verfolgt. Querschnittsdaten einer repräsentativen Befragung von Menschen ab 80 Jahren ( n = 1863) wurden Chi 2- und Kruskal-Wallis-Tests unterzogen, um Unterschiede in EGW nach Merkmalen der Person, ihrer Biographie und ihres aktuellen Lebensstils zu analysieren. Der Einfluss dieser Merkmale auf EGW wurde mit linearen Regressionsmodellen abgeschätzt. Semistrukturierte Interviews mit Stakeholdern zentraler Gesellschaftsbereiche ( n = 22) wurden mittels qualitativer Inhaltsanalyse hinsichtlich zum Ausdruck kommender Stereotype über HA untersucht. Die quantitativen und qualitativen Ergebnisse wurden einander gegenübergestellt.

          Ergebnisse

          EGW konnte durch gesundheitsbezogene Variablen und produktive Aktivitäten vorhergesagt werden. Einige der Stakeholder betonten, dass einerseits altersbedingte Verluste hochaltrige Menschen, deren Familien sowie die Gesellschaft vor Herausforderungen stellen, und andererseits verbleibende Potenziale im Alter zugunsten anderer eingesetzt werden können und sollen. Die Ansichten der Stakeholder unterschieden sich jedoch nach dem Ausmaß ihres beruflichen Kontakts zu (sehr) alten Menschen. Es wurden Wege vorgeschlagen, über die die beobachteten Stereotype und Determinanten von EGW miteinander verbunden sein können (z. B. Internalisierung von Stereotypen).

          Diskussion

          Die Studie verdeutlicht die Relevanz externaler Standards für individuelle LQ und betont die Notwendigkeit einer normativen Perspektive in der Diskussion um LQ und deren Förderung.

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          Most cited references52

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          The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research.

          To develop the Self-Administered Comorbidity Questionnaire (SCQ) and assess its psychometric properties, including the predictive validity of the instrument, as reflected by its association with health status and health care utilization after 1 year. A cross-sectional comparison of the SCQ with a standard, chart abstraction-based measure (Charlson Index) was conducted on 170 inpatients from medical and surgical care units. The association of the SCQ with the chart-based comorbidity instrument and health status (short form 36) was evaluated cross sectionally. The association between these measures and health status and resource utilization was assessed after 1 year. The Spearman correlation coefficient for the association between the SCQ and the Charlson Index was 0.32. After restricting each measure to include only comparable items, the correlation between measures was stronger (Spearman r = 0.55). The SCQ had modest associations with measures of resource utilization during the index admission, and with health status and resource utilization after 1 year. The SCQ has modest correlations with a widely used medical record-based comorbidity instrument, and with subsequent health status and utilization. This new measure represents an efficient method to assess comorbid conditions in clinical and health services research. It will be particularly useful in settings where medical records are unavailable.
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            Intercoder Reliability in Qualitative Research: Debates and Practical Guidelines

            Evaluating the intercoder reliability (ICR) of a coding frame is frequently recommended as good practice in qualitative analysis. ICR is a somewhat controversial topic in the qualitative research community, with some arguing that it is an inappropriate or unnecessary step within the goals of qualitative analysis. Yet ICR assessment can yield numerous benefits for qualitative studies, which include improving the systematicity, communicability, and transparency of the coding process; promoting reflexivity and dialogue within research teams; and helping convince diverse audiences of the trustworthiness of the analysis. Few guidelines exist to help researchers negotiate the assessment of ICR in qualitative analysis. The current article explains what ICR is, reviews common arguments for and against its incorporation in qualitative analysis and offers guidance on the practical elements of performing an ICR assessment.
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              Caregiver burden may result from providing care for patients with chronic illness. It can occur in any of the 43.5 million individuals providing support to midlife and older adults. Caregiver burden is frequently overlooked by clinicians. To outline the epidemiology of caregiver burden; to provide strategies to diagnose, assess, and intervene for caregiver burden in clinical practice; and to evaluate evidence on interventions intended to avert or mitigate caregiver burden and related caregiver distress. Cohort studies examining the relation between demographic and social risk factors and adverse outcomes of caregiver burden were reviewed. Review of recent meta-analyses to summarize the effectiveness of caregiver burden interventions were identified by searching Ovid MEDLINE, AgeLine, and the Cochrane Library. Risk factors for caregiver burden include female sex, low educational attainment, residence with the care recipient, higher number of hours spent caregiving, depression, social isolation, financial stress, and lack of choice in being a caregiver. Practical assessment strategies for caregiver burden exist to evaluate caregivers, their care recipients, and the care recipient's overall caregiving needs. A variety of psychosocial and pharmacological interventions have shown mild to modest efficacy in mitigating caregiver burden and associated manifestations of caregiver distress in high-quality meta-analyses. Psychosocial interventions include support groups or psychoeducational interventions for caregivers of dementia patients (effect size, 0.09-0.23). Pharmacologic interventions include use of anticholinergics or antipsychotic medications for dementia or dementia-related behaviors in the care recipient (effect size, 0.18-0.27). Many studies showed improvements in caregiver burden-associated symptoms (eg, mood, coping, self-efficacy) even when caregiver burden itself was minimally improved. Physicians have a responsibility to recognize caregiver burden. Caregiver assessment and intervention should be tailored to the individual circumstances and contexts in which caregiver burden occurs.
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                Author and article information

                Contributors
                marcella.reissmann@uni-koeln.de
                Journal
                Z Gerontol Geriatr
                Z Gerontol Geriatr
                Zeitschrift Fur Gerontologie Und Geriatrie
                Springer Medizin (Heidelberg )
                0948-6704
                1435-1269
                1 October 2021
                1 October 2021
                2021
                : 54
                : Suppl 2
                : 93-100
                Affiliations
                [1 ]GRID grid.6190.e, ISNI 0000 0000 8580 3777, Cologne Center for Ethics, Rights, Economics, and Social Sciences of Health, , University of Cologne, ; Albertus Magnus Platz, 50923 Cologne, Germany
                [2 ]GRID grid.6190.e, ISNI 0000 0000 8580 3777, a.r.t.e.s. Graduate School for the Humanities Cologne, , University of Cologne, ; Cologne, Germany
                [3 ]GRID grid.411097.a, ISNI 0000 0000 8852 305X, Research Unit Ethics, Medical Faculty, , University Hospital Cologne, ; Cologne, Germany
                Article
                1971
                10.1007/s00391-021-01971-y
                8551093
                34599385
                8ccbecab-3765-4ddc-8912-376e253c5a74
                © The Author(s) 2021

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 15 March 2021
                : 30 August 2021
                Funding
                Funded by: Universitätsklinikum Köln (8977)
                Categories
                Original Contributions
                Custom metadata
                © Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2021

                stereotypes,very old,society,quality of life,mixed methods,stereotype,hochaltrigkeit,gesellschaft,lebensqualität,mixed-methods

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