ABSTRACT
The proportion of the population with multiple illnesses increases with age and growing numbers of people are now living to a very old age. Despite medical progress and improved living conditions, many old people have to deal with physical, psychological, and social impairments. It is a crucial challenge for health and social policy to support the elderly with health-related impairments in their desire to lead as independent a life as possible. Against this background the research consortium Autonomy Despite Multimorbidity in Old Age (AMA I) examined the extent to which the self-determined life style of multimorbid old and very old persons can be supported and maintained. In order to reflect the diversity of life worlds of the elderly, the study sample included participants who were not notably impaired in their everyday functioning, participants in need of nursing care and participants with cognitive impairments. Moreover, the sample comprised both older persons who were still living in their own homes and nursing home residents. The studies conducted within the AMA framework focused on the resources available to old persons living in different situations and on how these resources can be strengthened. This article presents findings from the first phase of funding of the AMA research consortium. In a second phase of funding (2011-2013, AMA II), sustainable practice-based interventions are being developed to mobilize resources which can help multimorbid older persons to maintain their autonomy and the practical viability of these interventions will be tested.
Subject(s)
Chronic Disease/epidemiology , Clinical Trials as Topic , Comorbidity , Evidence-Based Medicine , Health Services Research/organization & administration , Health Services for the Aged , Interinstitutional Relations , Aged , Aged, 80 and over , Germany , Humans , United StatesABSTRACT
Action planning is assumed to mediate between intentions and health behaviours. Moreover, intentions are assumed to moderate the planning-behaviour relation, because people with high intentions are more likely to enact their plans. The present studies extend these suppositions by integrating both assumptions to a novel and parsimonious model of moderated mediation: the mediation effect is hypothesised to be stronger in individuals who report higher intention levels. In two longitudinal studies on physical activity (N = 124) and interdental hygiene (N = 209), intentions and action planning were assessed at baseline, and behaviour was measured four (Study 1), and respectively, three (Study 2) months later. The moderated mediation hypothesis was tested with continuously measured intentions using regression analyses with non-parametric bootstrapping. Results from both studies suggest that levels of intentions moderate the mediation process: The strength of the mediated effect increased along with levels of intentions. Planning mediates the intention-behaviour relation, if individuals hold sufficient levels of intentions. Implications for theory advancement and intervention development are discussed.
Subject(s)
Health Behavior , Intention , Adult , Aged , Aged, 80 and over , Exercise , Female , Germany , Humans , Longitudinal Studies , Male , Middle Aged , Oral HygieneABSTRACT
BACKGROUND: Stress is an etiologic factor of pain-relevant craniomandibular disorders (CMD). Interindividual differences in coping with stress and their relation to CMD have rarely been examined. PATIENTS AND METHODS: A total of 72 volunteers (20 men, 52 women) were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders. Stress parameters and coping skills were assessed by questionnaires. RESULTS: Stress and one coping factor are correlated with CMD indices. Linear regression analysis found the Life Event Score and cognitive coping by changing appraisals to significantly predict CMD. CONCLUSION: Stress and coping skills are independent predictors of CMD.