Association of frailty with workplace social activity, physical activity, and well-being among older employees: a moderated mediation in two income-variant samples.

BACKGROUND: Research suggests that frailty is associated with lower physical activity and well-being in old age, but social activities at work may facilitate physical activity and its positive effect on well-being among older employees with frailty. This study, therefore, ascertained whether there is a moderated mediation of the association of frailty, Workplace Social Activity (WSA), and well-being by Physical Activity (PA). METHODS: The study adopted a cross-sectional design with relevant sensitivity analyses for confounding. The participants were within two Ghanaian samples with different income levels (low-income, n = 897, and higher income, n = 530). The minimum samples were calculated, and the statistical models were tested with Haye's Process Model through structural equation modelling. RESULTS: Frailty was negatively associated with PA, and this relationship was moderated by WSA in both samples. Higher frailty was directly and indirectly associated with lower well-being in the higher-income sample but only indirectly associated with lower well-being in the low-income sample. The mediation of PA in the frailty-well-being relationship is partial in the higher-income sample but complete in the low-income sample. There was evidence of moderated mediation in both samples. CONCLUSION: WSA may reduce the strength of the negative association of frailty with PA and well-being among older employees in both samples. Workplace interventions aimed at enhancing WSA may encourage PA and enhance well-being among older employees with frailty.

Associations of frailty with partial and absolute sedentary behaviours among older adults: A STROBE-compliant analysis of modifiability by gender and age.

BACKGROUND: Research shows that frailty is associated with higher sedentary behaviour, but the evidence to date regarding this association is inconclusive. This study assessed whether the above association is moderated or modified by gender and age, with sedentary behaviour measured with a more inclusive method. METHODS: This study adopted a STROBE-compliant cross-sectional design with sensitivity analyses and measures against common methods bias. The participants were community-dwelling older adults (mean age = 66 years) in two Ghanaian towns. A self-reported questionnaire was used to collect data from 1005 participants after the minimum sample size necessary was calculated. The hierarchical linear regression analysis was used to analyse the data. RESULTS: After adjusting for the ultimate confounders, frailty was associated with higher sedentary behaviour (ß = 0.14; t = 2.93; p <0.05) as well as partial and absolute sedentary behaviour. Gender modified the above associations in the sense that frailty was more strongly associated with sedentary behaviour among women, compared with men. Age also modified the association between frailty and sedentary behaviour, which suggests that frailty was more strongly associated with higher sedentary behaviour at a higher age. CONCLUSION: Sedentary behaviour could be higher at higher frailty among older adults. Frailty is more strongly associated with sedentary behaviour at a higher age and among women, compared with men.

Associations between vigorous physical activity, social ties, social support, and self-reported health among older adults in Accra, Ghana.

Meeting recommended vigorous physical activity (VPA) levels represents a hallmark for healthy living, but VPA in older populations is likely to lead to casualties that may compel older adults to underscore their health. This study examined the associations between VPA, social ties, social support, and self-reported health in an African sample of older adults. This study adopted the cross-sectional design. The study population was community-dwelling older adults aged 60 years or higher in Accra, Ghana. A total of 686 older adults responded to self-reported questionnaires. Data were analysed with the Pearson's chi-square test and binary logistic regression. The study found that older adults who had above 5 children were 3 times (AOR = 3.169; p = .002) more likely to participate in VPA for 30 minutes or more a day compared with their peers without children. Having social support from between 1 and 5 people was 28 times (AOR = 28.215; p = .000) more likely to result in good health compared to not having anyone to source social support from. Older adults who participated in VPA for 30 minutes or more were less likely (AOR = 0.129; p = 0.000) to report good health compared with those who participated in VPA for less than 30 minutes. We conclude that when social ties and other personal characteristics are adjusted for, prolonged VPA does not necessarily enhance self-reported health, and not all social ties contribute to VPA and self-reported health.

Associations of Social Networks with Physical Activity Enjoyment among Older Adults: Walkability as a Modifier through a STROBE-Compliant Analysis.

The available evidence suggests that social networks can contribute to physical activity (PA) enjoyment, which is necessary for the maintenance of PA over the life course. This study assessed the associations of active and sedentary social networks with PA enjoyment and ascertained whether walkability moderates or modifies these associations. A cross-sectional design compliant with STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) was employed. The participants were 996 community-dwelling older Ghanaians aged 50 years or older. A hierarchical linear regression analysis was used to analyse the data. After adjusting for age and income, the study found that the active social network size (ß = 0.09; p < 0.05) and sedentary social network size (ß = 0.17; p < 0.001) were positively associated with PA enjoyment. These associations were strengthened by walkability. It is concluded that active and sedentary social networks may better support PA enjoyment in more walkable neighbourhoods. Therefore, enabling older adults to retain social networks and live in more walkable neighbourhoods may be an effective way to improve their PA enjoyment.

The association between nurses' physical activity counselling and patients' perceptions of care quality in a primary care facility in Ghana.

Many countries including Ghana and Australia have adopted physical activity (PA) counselling in healthcare as a public health improvement strategy. Even so, more evidence is needed to improve clinical PA counselling among clinicians, including nurses. This study examined the association between nurses' physical activity counselling (NPAC) and patients' perceptions of care quality. The study adopted a cross-sectional design with a sensitivity analysis against potential confounding. The setting of the study was a public primary care facility in Darkuman, Accra. Participants were 605 patients in wards and the Outpatient Department of the facility. Data were collected using a self-reported questionnaire and analyzed using structural equation modeling. A sensitivity analysis was conducted to select potential confounding variables for the study. The study found that higher care quality was associated with larger scores of NPAC (ß = 0.34; CR = 8.65; p = 0.000). NPAC has no significant direct association with patient satisfaction (ß = 0.01; CR = 0.22; p > 0.05) and loyalty (ß = 0.05; CR = 1.21; p > 0.05), but care quality and patient satisfaction fully mediate the association between NPAC and patient loyalty. It is concluded that NPAC in healthcare can improve care quality and indirectly increase patient satisfaction and loyalty through care quality. The incorporation of PA counselling into clinical nursing may, therefore, be consistent with the core mission of hospitals.

Associations between older African academics' physical activity, walkability and mental health: a social distancing perspective.

This study aimed to assess the moderating influence of neighborhood walkability on the association between physical activity (PA) and mental health among older African academics aged 50 years or more in cities with social distancing protocols in response to the Coronavirus disease 2019 (COVID-19). A total of 905 volunteer academics participated in the study. A hierarchical linear regression analysis was employed to conduct sensitivity analyses and test the study hypotheses. After controlling for sex, education and age, there was a positive association between PA and mental health. Neighborhood walkability moderated the relationship between PA and mental health, which suggests that during the pandemic PA was associated with higher mental health scores in more walkable neighborhoods. The study concludes that PA was beneficial to mental health in the social distancing context and was associated with higher mental health in more walkable neighborhoods, particularly in a social distancing context.

Psychometric Properties of a New Scale Measuring Neglect and Abuse of Older Adults in the Community: Implications for Social Activity.

BACKGROUND: Neglect and abuse of older adults are still prevalent in communities of developing countries, a situation that could discourage active and healthy behaviors in community-dwelling older adults. METHODS: This study used the cross-sectional and correlational approaches to construct a scale measuring neglect and abuse in older adults living in the community. The study population was all (3,211) older adults who were resident in Accra and were part of the database of the Social Security and National Insurance Trust. Participants were 515 individuals who met some inclusion criteria. Three steps were followed to determine an initial set of 11 items, and principal component analysis with varimax rotation and confirmatory factor analysis were used to select relevant items and assess the psychometric properties of the final scale. RESULTS: Principal component analysis with varimax rotation yielded a two-factor solution on all 11 items. The first factor extracted was "discrimination and exploitation," which accounted for a variance of 53.9% out of total variance of 70.8%. The scale had a good internal consistency (Cronbach's α = .90, factor loading ≥0.50). Confirmatory factor analysis confirmed the two-factor solution and produced satisfactory convergent and discriminant validity. CONCLUSION: It is concluded that 11 items that make up 2 factors are potential indicators of neglect and abuse of older adults at the community level. Finally, neglect and abuse of older people in the community can contribute to an increase or decrease in social activity.

The Influence of Physicians' Physical Activity Prescription on Indicators of Health Service Quality.

INTRODUCTION: Many researchers are of the opinion that the incorporation of physical activity prescription (PAP) into healthcare is a move that can add value to healthcare, but there are others who think this move would rather disrupt clinical practice. This study, therefore, examined the influence of physicians' PAP (PPAP) on healthcare quality indicators. METHODS: The study adopted a correlational approach and was performed at a primary care facility. Participants were 605 patients in wards and the outpatient department of a district healthcare facility. A self-reported questionnaire was used to gather data. Structural equation modeling was used to present findings. RESULTS: The study found that PPAP has a positive influence on care quality (ß = 0.4, critical ratio = 10.59, and p = .000), patient satisfaction, and patient loyalty. Physical activity prescription also has a positive indirect influence on patient loyalty through patient satisfaction. CONCLUSIONS: Physicians' physical activity prescription in healthcare can improve healthcare quality indicators. A key implication of our results is that the incorporation of PPAP into healthcare could be in harmony with the key mission of hospitals. Physical activity prescription in healthcare could be a way to satisfy and retain patients.

The Built Environment and Socio-Demographic Correlates of Partial and Absolute Sedentary Behaviours in Community-Dwelling Older Adults in Accra, Ghana.

This study examined built environmental and socio-demographic variables as correlates of sedentary behaviour in a population of older adults, and attempted to introduce the idea of measuring sedentary behaviour with two domains, namely 'partial sedentary behaviour' and 'absolute sedentary behaviour'. The study's population was community-dwelling older adults aged 60 years or more in Accra, Ghana. A self-reported questionnaire was used to gather data from 504 older people. Multiple linear regression analysis was used to present findings, with all nominal categorical variables incorporated in this analysis dummy-coded. The overall (third) regression model accounted for a variance of 55.9% and a significant F-test [F (25,454) = 22.99; p < 0.001)]. Gender was positively associated with sedentary behaviour - the sedentary behaviour of women was 28 min in excess of that of men. Sedentary behaviour decreased as the social network size and supporting social network of older people increased. Sedentary behaviour decreased as availability of spacious road pavements, secure social recreational centres for older people, and health services in the community increased. The improvement of road safety conditions at the community level and design of the built environment to support social integration of older people are major recommendations of this study.

The Influence of Community-Level Built Environment Factors on Active Social Network Size in Older Adults: Social Activity as a Moderator.

BACKGROUND: This study examined the influence of built environmental factors in the community on active social network size as well as the moderating influence of different dimensions of social activity on this relationship. METHODS: This study employed the cross-sectional and correlational approaches to construct a scale measuring key community-level built environment factors and test the moderating influence of social activity on the association between these factors and active social network size in older adults. The study population was all 3,211 older adults who were resident in Accra and were part of the database of the Social Security and National Insurance Trust. Participants were 515 older adults in Accra aged 60 years or more who met some inclusion criteria. A self-reported questionnaire, including a new scale measuring the built environment factors, was used to collect data. Principal component analysis with varimax rotation and confirmatory factor analysis were used to validate the measurement scales, whereas Pearson's correlation test and multiple linear regression analysis were used to test the associations of interest. RESULTS: After controlling for relevant demographic variables, built environment factors in the community have no significant influence on active social network size. Volunteering, support for social ties, and group activity positively moderated the influence of built environment factors on active social network size at p < .05 and ß ≥ 0.2. CONCLUSION: The study concludes that social activity is essential to the utilization of available built environmental factors by older adults to make active social ties in the community.

Influence of nurse and midwife managerial leadership styles on job satisfaction, intention to stay, and services provision in selected hospitals of Rwanda.

BACKGROUND: Nurses and midwives are a critical part of the healthcare team and make up the largest section of health professionals. Leadership styles are believed to be an important determinant of job satisfaction and retention making effective leadership within nursing and midwifery crucial to health systems success. In Rwanda, there are gaps in knowledge of managerial leadership styles of nurses and midwives and the influence of these styles on job satisfaction and retention for nurses and midwives who report to them, as well as their influence on the provision of health services. This study describes the managerial leadership styles adopted by nurses/midwives and examines the relationship between managerial leadership styles and job satisfaction, intention to stay, and service provision. METHODS: The Path-Goal Leadership questionnaire was adopted and used to collect data on leadership styles while other questionnaires with high validity and reliability were used to collect data on job satisfaction, intention to stay and service provision. The study involved 162 full-time nurses and midwives practicing in 5 selected hospitals with a minimum of 6 months of experience working with their current direct managers. Regression analysis was used to draw conclusions on relationships between variables. RESULTS: Nurses and midwives managers were more inclined to the directive leadership style followed by a supportive leadership style, and the participative leadership style. The nurse and midwife's managerial leadership styles together significantly explained 38, 10 and 23% of the variance in job satisfaction, intention to stay and service provision, respectively. CONCLUSION: The findings of this study indicate that managerial leadership styles play a substantial role in enhancing job satisfaction, intention to stay and service provision. THE IMPLICATION FOR NURSING AND MIDWIFERY MANAGEMENT: There is a need to develop a comprehensive formal professional continuous development course on leadership styles and ensure that all nurses and midwives managers benefit from this course prior to or immediately after being appointed as a manager. Having such a course may even prepare future leaders for their role early in their career. Effective leadership in nursing and midwifery should be enhanced at all levels to improve the job satisfaction of nurses and midwives, address the issue of retention in their respective health facilities and strengthen service provision.