Factors related to quality of life in community-dwelling adults in Sleman Regency, Special Region of Yogyakarta, Indonesia: Results from a cross-sectional study.

BACKGROUND: Quality of life studies in low- and middle-income countries have demonstrated the influence of socioeconomic factors on the quality of life (QoL). However, further studies are required to confirm this association in developing countries with rapidly ageing populations. Using Ferrans et al.'s QoL model, this study aimed to identify the factors associated with the QoL of community-dwelling adults in Indonesia. METHODS: A cross-sectional study among 546 community-dwelling adults aged 50+ years was conducted in Yogyakarta, Indonesia, in 2018. QoL was measured using the Short Form 12 questionnaire, which consists of a summary of physical and mental health. We performed stepwise logistic regression analyses to determine odds ratios (ORs) with 95% confidence intervals (CIs) and examined the association between the QoL (physical and mental health) and demographic characteristics, socioeconomic status, financial management behaviour, multimorbidity status, nutritional status, cognitive impairment status, depression status, and independence. Statistical significance was set at p<0.05. RESULTS: Among the respondents, 15% reported poor physical health, and 9.2% reported poor mental health. Good physical health was significantly associated with the absence of chronic disease (OR 2.39; 95% CI: 1.07-5.33), independence in activities of daily living (OR 3.90; 95% CI 1.57-9.67) and instrumental activities of daily living (OR 4.34; 95% CI 2.28-8.26). Absence of depression was significantly associated with good mental health (OR 2.80; 95% CI 1.3-5.96). CONCLUSION: The QoL of community-dwelling adults in Indonesia is associated with activities of daily living and instrumental activities of daily living, as well as the absence of chronic disease and depression. Efforts should be made to prevent chronic disease and delay functional decline through healthy lifestyles and routine physical and mental health screenings.

"We don't really do doctors." messages from people diagnosed with occupational leptospirosis for medical professionals on infection, hospitalisation, and long-term effects.

Leptospirosis is largely an occupational disease for people working with livestock in Aotearoa New Zealand. Introduction of livestock vaccination and use of personal protective equipment has been associated with a reduction in the incidence. However, the incidence of occupational leptospirosis remains high, with significant burdens for affected families and healthcare system. For this article, a subset of thirteen participants from a nationwide leptospirosis case-control study (2019-2021) who were diagnosed with leptospirosis and worked with livestock at the time of illness were invited and agreed to a semi-structured interview. Interviewees reflected on their experiences as messages for medical professionals. The analysis of transcripts reveals widely shared experiences with infection, hospitalisation, and treatment, as well as long-term effects and recovery. Conclusions for medical professionals include that ill workers continue to have their diagnosis of leptospirosis delayed. This delay may contribute to more than half the people ill with leptospirosis hospitalised. Further, medical professionals' communication and relationship with ill people strongly colours the latter's experience, for good or for bad. Moreover, most interviewees experienced a recovery process that took several months of feeling tired, which undermined professional performance and emotional wellbeing.

Leptospirosis in Aotearoa New Zealand: Protocol for a Nationwide Case-Control Study.

BACKGROUND: In Aotearoa New Zealand, 90% of patients with notified leptospirosis (a zoonotic bacterial disease) have been men working in agricultural industries. However, since 2008, the epidemiology of notified cases has been gradually changing, that is, more women are affected; there are more cases associated with occupations traditionally not considered high risk in New Zealand; infecting serovars have changed; and many patients experience symptoms long after infection. We hypothesized that there is a shift in leptospirosis transmission patterns with substantial burden on affected patients and their families. OBJECTIVE: In this paper, we aimed to describe the protocols used to conduct a nationwide case-control study to update leptospirosis risk factors and follow-up studies to assess the burden and sources of leptospirosis in New Zealand. METHODS: This study used a mixed methods approach, comprising a case-control study and 4 substudies that involved cases only. Cases were recruited nationwide, and controls were frequency matched by sex and rurality. All participants were administered a case-control questionnaire (study 1), with cases being interviewed again at least 6 months after the initial survey (study 2). A subset of cases from two high-risk populations, that is, farmers and abattoir workers, were further engaged in a semistructured interview (study 3). Some cases with regular animal exposure had their in-contact animals (livestock for blood and urine and wildlife for kidney) and environment (soil, mud, and water) sampled (study 4). Patients from selected health clinics suspected of leptospirosis also had blood and urine samples collected (study 5). In studies 4 and 5, blood samples were tested using the microscopic agglutination test to test for antibody titers against Leptospira serovars Hardjo type bovis, Ballum, Tarassovi, Pomona, and Copenhageni. Blood, urine, and environmental samples were also tested for pathogenic Leptospira DNA using polymerase chain reaction. RESULTS: Participants were recruited between July 22, 2019, and January 31, 2022, and data collection for the study has concluded. In total, 95 cases (July 25, 2019, to April 13, 2022) and 300 controls (October 19, 2019, to January 26, 2022) were interviewed for the case-control study; 91 cases participated in the follow-up interviews (July 9, 2020, to October 25, 2022); 13 cases participated in the semistructured interviews (January 26, 2021, to January 19, 2022); and 4 cases had their in-contact animals and environments sampled (October 28, 2020, and July 29, 2021). Data analysis for study 3 has concluded and 2 manuscripts have been drafted for review. Results of the other studies are being analyzed and the specific results of each study will be published as individual manuscripts.. CONCLUSIONS: The methods used in this study may provide a basis for future epidemiological studies of infectious diseases. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/47900.

Social environment and quality of life among older people with diabetes and multiple chronic illnesses in New Zealand: Intermediary effects of psychosocial support and constraints.

PURPOSE: In older people with diabetes, multimorbidity is highly prevalent and it can lead to poor quality of life. The overall purpose of this study was to examine the association between the social environment, psychosocial support and constraints, and overall quality of life among older people with and without with diabetes and multiple chronic illnesses. METHODS: Self-reported data from participants in a cohort study of older New Zealanders was analysed. Responses from 380 older people diagnosed with diabetes and multiple chronic illnesses were compared with 527 older people with no health issues on indicators related to the associations of neighbourhood, health and ageing, using structural equation modelling. RESULTS: The final model suggests that social provision, purpose in life and capabilities mediated between the social environment and quality of life, indicate that older people with positive social environment (i.e., neighbourhood advantage, residential stability) are much less likely to experience depression due to having good social support, meaningful life purpose and opportunities to engage. CONCLUSIONS: Perceived neighbourhood advantages, such as positive neighbourhood qualities, social cohesion and housing satisfaction, along with the focus on increasing social support, enhancing purpose in life and supporting one's capability to achieve, may serve as protective factors against depression.IMPLICATIONS FOR REHABILITATIONEnvironmental and personal circumstances can contribute to quality of life among older people with diabetes and multimorbidity.By providing older people with diabetes and multiple chronic illnesses a socially just environment that challenges ageism and other forms of oppression, this could reduce social disparities in health, improve inclusion and access to resources.Social and healthcare professionals are encouraged to design clinical care guidelines and rehabilitation goals from a wholistic and person/client centred approach to support older people with diabetes and multiple chronic illnesses.

Interactions between the Public and Assistance Dog Handlers and Trainers.

This research aimed to explore the experiences of handlers and trainers of disability assistance dogs in terms of the types of interactions they had with members of the Aotearoa NZ (NZ) public and how these interactions were perceived, interpreted, and managed. A qualitative method, guided by an interpretive approach and social constructionism, was utilised to collect data via semi-structured interviews with six handlers and six trainers of assistance dogs. Data were analysed using thematic analysis with the social model of disability as the theoretical base. Findings indicated that participants regularly faced a complex range of unique interactions due to various factors such as the public's lack of knowledge and understanding of the dog's role and right of access to public places. While participants encountered brief friendly comments about the dog and its role, other encounters involved long conversations, invasive personal questions, interference with their dogs, and denied access to businesses, cafés, restaurants, and public transport. These findings underpin the need to provide more education to the public on the etiquette of engaging with handlers and their assistance dogs and more support for businesses to understand the legal rights of handlers. Through education and support to change societal attitudes and remove structural barriers, disabled people using assistance dogs may be able to independently participate in community life and be fully included without hindrance.

What Helps Oiled Wildlife Responders Care for Animals While Minimizing Stress and Compassion Fatigue.

Oil spills are environmental disasters and their long-term impact is not just a concern for the environment and economy, but also for first responders' health and wellbeing. Wildlife, such as aquatic birds and certain marine mammals, are highly susceptible to physiological effects of oiling, and oiled wildlife responders are crucial to provide measures for their survival. The purpose of this research was to explore the experiences of oiled wildlife responders and what factors and conditions have helped or inhibited the responders to care-affected wildlife. This study collected responses (n = 50) from a survey of responders who attended either the New Zealand MV Rena or US Refugio pipeline oil spills. Study participants were mostly older (>40), highly educated females. We found there were significant differences in compassion satisfaction, resilience, burnout and overall satisfaction based on age, gender and role. While most responders have only attended limited numbers of oil spill incidents, they reported positive experiences and found it rewarding. Findings from responders indicated that to lessen stress and compassion fatigue during an incident, provision of training and support from professional organizations equips responders with knowledge and skills that can support their personal resilience to respond to disaster events.

Quality of life among older people with a disability: the role of purpose in life and capabilities.

Purpose: Purpose in life and capabilities are two significant individual elements that enhance quality of life among older people. Capabilities refers to the extent to which older people are free to make choices that are important to them. At present, it is not known how purpose in life interacts with capabilities to influence quality of life for those living with a disability. This study examined the extent to which purpose in life and capabilities interacts with health status to affect quality of life, particularly for older people with a disability.Methods: Self-report data from participants in a longitudinal cohort study of older New Zealanders were analyzed. Responses from 452 older people with a disability were compared with 3299 age- and gender-matched older people without a disability on indicators related to health and aging. The associations were tested using hierarchical regression. Mediational impact of purpose in life and capabilities were tested via path analysis.Results: Mental health, physical health, purpose in life, and capabilities accounted for a significant amount of variance in quality of life for older people with a disability. Purpose in life and capabilities were significant unique mediators for older people with a disability.Conclusions: Purpose in life may help older people with a disability to deal with early onset stressors or changes in mental and physical health to maintain overall quality of life. The role of capabilities suggests that the social environment and access to resources and choices are important in ensuring that older people aging with or into a disability achieve quality of life in a socially just environment.Implications for rehabilitationsPurpose in life and capability are unique mediators of the relationship between health status and quality of life.Purpose in life may act as an effective buffering mechanism to deal with disability in later life while capability can empower older people with a disability to achieve quality of life in a just environment.The notion of successful aging with disability should be re-defined as using psychological, social support, and healthcare resources to live a life consistent with personal values in the context of disabilityRather than emphasizing structural factors and physical functioning in activity participation, older people with disability should be supported to decide and pursue their own preferences.Rehabilitation professionals can work flexibly with older people with disability to maximize their resilience, dignity, autonomy and choice, and positive connection to others.

The Relationship Between Childhood Circumstances and Late Life Physical and Mental Health: The Role of Adult Socioeconomic Status.

OBJECTIVES: Socioeconomic status and health in childhood are linked to health outcomes in later life. Health outcomes may also be shaped by socioeconomic circumstances in adulthood and later life. This paper examined the relationship between childhood conditions and later life health and tested whether this relationship was mediated by later life economic living standards. METHODS: Data from a longitudinal study of aging was combined with retrospective life history data from 787 participants from the New Zealand Health, Work and Retirement Study. RESULTS: Significant relationships were found between childhood conditions and later life health. These relationships were mediated by economic living standards in older age, but the partial direct effect of childhood conditions on health found in early older age became fully meditated 10 years later. CONCLUSION: While childhood circumstances are part of this complex relationship, socioeconomic conditions in later life are vital to ensuring ongoing health into older age.

Pet ownership and its influence on mental health in older adults.

Objectives: With aging, older adults are at risk of a decline in mental health as they experience significant life stressors that are specific to later life. It is thus important to explore the potential of suitable approaches that promote healthy aging, to address the mental health needs of older adults. Pet ownership has been found to be associated with positive mental health outcomes; however, there is limited research on the lived experience and meaning derived from pet ownership. The purpose of this study was to explore pet ownership in community-dwelling older adults and its influence on mental health.Methods: Semi-structured interviews were conducted with 14 community-dwelling older adults who were aged 65 and above and pet owners. Participants were interviewed individually on a single occasion about the meaning derived from the role of pet ownership and howthey perceived that their pet influenced their mental health.Results: Results were analysed using Colaizzi's phenomenological framework and four themes emerged from the interviews: pets provide (i) comfort and safety; (ii) social inclusion and participation; (iii) purposeful routine and structure; and (iv) a meaningful role.Conclusion: These findings suggest that the role of pet ownership may benefit community-dwelling older adults by providing companionship, giving a sense of purpose and meaning, reducing loneliness and increasing socialisation. These benefits may also increase resilience in older adults against mental health disorders, which may positively influence their mental health outcomes.

Understanding the Relationship Between Pet Ownership and Physical Activity Among Older Community-Dwelling Adults-A Mixed Methods Study.

Pet ownership is associated with increased levels of physical activity (PA) in older adults. Studies have mainly focused on the association between PA and dog walking; however, broader aspects of pet ownership may influence PA. The purpose of this study was to explore the association between pet ownership and incidental and purposeful PA using a mixed methods approach. Participants' (N = 15) PA was measured for 7 days using accelerometers and diaries. Semistructured interviews explored participants' perspectives regarding pet-related activities. Participants' mean (SD) daily step count was 14,204 (5,061) steps, and mean (SD) sedentary time per day was 8.76 (1.18) hr. Participants strongly concurred that their pets were an integral part of their daily lives. Incidental and purposeful PA resulted from participants undertaking pet care and socially interacting with their pets. Pets may interrupt sedentary behaviors by nudging older adults to engage in PA as part of their daily lived experience.

Risk and protective factors for wellbeing in older veterans in New Zealand.

Objectives: To compare indicators relating to aging and health among veterans and non-veterans, and identify factors associated with subjective wellbeing (SWB) of older New Zealand veterans. Methods: Self-reported data were obtained from participants in a longitudinal cohort study of New Zealand older adults. Responses from 352 veterans and 1500 non-veterans (age range of 55-86 and gender matched) were selected as a comparison group on indicators related to health and aging. The association of these indicators with veterans' SWB were assessed using hierarchical regression. Results: Apart from being older, smoking more, and having more chronic conditions, veterans did not differ from non-veterans on indicators of health and wellbeing. Mental health, physical health, purpose in life, housing satisfaction, and capabilities (choice and freedom) accounted for a significant amount of variance in veterans' SWB. Conclusion: Our results suggest that older veterans do not differ greatly on indices of health and aging from their non-veteran peers. Results support previous findings that lower mental and physical health is associated with lower SWB for veterans. Building upon prior findings, the current results demonstrate that interventions focusing on enhancing a sense of purpose in life, supporting one's capability to achieve, and strengthening social and physical environment through social connectedness, may serve as protective factors for SWB in veterans.

Prevalence of key care indicators of pressure injuries, incontinence, malnutrition, and falls among older adults living in nursing homes in New Zealand.

Pressure injuries, incontinence, malnutrition, and falls are important indicators of the quality of care in healthcare settings, particularly among older people, but there is limited information on their prevalence in New Zealand (NZ). The aim of this study was to establish the prevalence of these four problems among older people in nursing home facilities. The cross-sectional study was an analysis of data collected on a single day for the 2016 National Care Indicators Programme-New Zealand (NCIP-NZ). The sample included 276 people ages 65 and older who were residents in 13 nursing home facilities in a geographically diverse area of central NZ. Data were analyzed with descriptive statistics. Prevalence rates in these nursing home settings was pressure injuries 8%; urinary incontinence 57%; fecal incontinence 26%; malnutrition 20%, and falls 13%, of which half resulted in injuries. As people age, complex health issues can lead to increasing care dependency and more debilitating and costly health problems. Measuring the prevalence of basic care problems in NZ healthcare organizations and contributing to a NZ database can enable monitoring of the effectiveness of national and international guidelines.

Stressors and Protective Factors among Veterinary Students in New Zealand.

A study was undertaken to investigate the stressors faced by veterinary students and the protective factors against those stressors. The study was conducted as a workshop during which students collaborated with their peers through an iterative process to identify personal and external factors that contributed to or protected against stress as a veterinary student, and then to suggest strategies that would protect their mental health and well-being. Workload and assessment were the most commonly reported stressors. Students reported a variety of effective coping strategies and avoidance behaviors, although most of the suggested solutions revolved around organizational change within the university. Students also recognized that their own perspectives, traits, and behavior could enhance their student experience or increase their perceived levels of stress. While it is important that educators monitor student feedback about the program and make changes when required, students must recognize that stress is an expected component of life and develop effective coping strategies. They should develop a balanced view of the positive and negative aspects of the student experience and, ultimately, of working as a veterinary professional.

Psychometric testing of a person-centred care scale the Eden Warmth Survey in a long-term care home in New Zealand.

BACKGROUND: Traditional nursing homes have been viewed as dominated by the medical model. Since the 1990s, the Eden Alternative(TM) has become a significant model in systemic transformations in nursing homes. The purpose of this study was to evaluate the psychometric performance of the 20 items of the Eden Warmth Survey - Residents (EWS-R) in an aged-care home. DESIGN: A resident's satisfaction survey was used to collect a sample of 85 long-term care home residents. METHODS: Psychometric evaluation included item analyses, reliability including internal consistency and stability, criterion-related validity and construct validity. RESULTS: The reduced 13 items demonstrated adequate reliability (α = 0.82) with two factors, Trust and Connectedness with Others and Care Practices, extracted and contributed to 57.9% of the total variance. CONCLUSIONS: The 13-item of EWS-R can be considered as a reliable and predictive scale for assessing quality of life and overall satisfaction on people living in long-term care facilities.

Using the capability approach to understand the determinants of subjective well-being among community-dwelling older people in New Zealand.

BACKGROUND: as the longevity of the population increases, attention has turned to quality of life of older people as a component of healthy ageing. The objective of this study was to use Welch Saleeby's model of the capability approach to explore the determinants of subjective well-being among older people. METHODS: this analysis used data from a sample of older people, aged 50-87, from 2012 wave of the New Zealand Longitudinal Study of Ageing (NZLSA) (n = 2,793). Structural equation modelling was used to examine the relationships between the commodities (number of chronic conditions reported, physical and mental health), and personal and environmental factors (economic living standard and discrimination), on the capabilities of older people to achieve well-being. RESULTS: the findings supported Welch Saleeby's model. Capabilities mediated the relationship between commodities and well-being, indicating that increasing the range of real opportunities available to older people is a key step in increasing well-being. Age and gender were also found to be significant moderators of these relationships. The relationship between economic living standards and well-being was weakest for the oldest participants, but experiences of discrimination had a stronger effect on well-being in this age group. CONCLUSION: Welch Saleeby's model of the capability approach provides a useful framework for advancing the ethics of care as it highlights the multidimensional nature of well-being in later life. Focusing on expanding capabilities for older people enables policymakers and practitioners to understand the resources and supports required to enable well-being in the context of health challenges.

Mobility, satisfaction with functional capacity and perceived quality of life (PQOL) in older persons with self-reported visual impairment: the pathway between ability to get around and PQOL.

BACKGROUND: Research shows that ability to get around (AGA) is significantly associated with perceived quality of life (PQOL) among older persons with self-reported visual impairment. Much of this impact, however, is through satisfaction with one's functional capacity. Satisfaction with functional capacity is a construct composed of five items: satisfaction with (1) activities of daily living, (2) capacity to work, (3) self, (4) health and (5) sleep. At present, it is not known how AGA interacts individually with these items to influence PQOL. PURPOSE: The purpose of this study is to investigate the extent to which AGA interacts with each of these five items to affect PQOL. METHODS: Structural equation modelling was employed in a secondary-analysis of data from 356 persons (aged 56-72) with self-reported visual impairment to identify the pathways by which AGA affects PQOL. RESULTS: Satisfaction with self and health were the only items found to be both directly related to QOL and to provide a significant pathway between AGA and PQOL. CONCLUSION: AGA significantly affects PQOL both directly and indirectly through its impact on people's satisfaction with self and health. Lessons may be learnt from this to better focus mobility interventions to enhance PQOL in this population.

Quality of life in indigenous and non-indigenous older adults: assessing the CASP-12 factor structure and identifying a brief CASP-3.

PURPOSE: We assessed whether the original three-factor structure of the older adult CASP-12 Quality of Life (QOL) scale was stable for both indigenous and non-indigenous older adult populations in the same non-European country (i.e. New Zealand). METHOD: A total of 3076 New Zealanders aged 50-84 (Maori = 1,130; non-Maori sample = 1,946) completed a postal survey for the first data collection wave of the New Zealand Longitudinal Study of Ageing in 2010. The survey included the CASP-12, a chronic health conditions checklist, CES-D-10, de Jong Gierveld loneliness scale, and the WHOQOL single-item QOL indicator. RESULTS: Exploratory factor analysis revealed that the CASP-12 responses resulted in a revised two-factor structure for both Maori and non-Maori we called the NZCASP-11, which included a new three-item global indicator of QOL (CASP-3) that consistently cross-loaded on both factors. Confirmatory factor analysis supported the NZCASP-11 factor structure over the original CASP-12 model, and further assessment validated both the utility of the NZCASP-11 as an indicator of QOL in New Zealand and illustrated the utility of the CASP-3 as a brief screen for global QOL. CONCLUSION: While CASP items coalesce to provide a robust QOL indicator of indigenous and non-indigenous QOL in a single-country setting, the actual factor structure underpinning this CASP indicator (i.e. the NZCASP-11) is not entirely reflective of that found in the United Kingdom. Furthermore, we revealed that three CASP items (i.e. the CASP-3) may reflect a stable brief indicator of QOL applicable for assessing QOL across cultures within a single setting.

An exploratory study examining the relationships between the personal, environmental and activity participation variables and quality of life among young adults with disabilities.

PURPOSE: Despite the apparent importance of International Classification of Functioning, Disability and Health (ICF) framework in influencing the relationships between participation and quality of life (QoL), limited research has been given to comprehensive modelling of their influence. The purpose of this study was to explore the relationships between ICF components, participation factors and QoL among young adults with disabilities. METHODS: This study tested a theoretically and empirically based explanatory model on 119 young adults with disabilities to examine how the variables of functional impact, financial behaviour, self-efficacy, neighbourhood environment, social support, social and community participation, satisfaction with participation influenced QoL. Analyses were performed with AMOS maximum likelihood parameter estimation. RESULTS: The final model accepted in this study showed a well-fitted model, which explained 65% of the variance in QoL. Results from the statistical modelling indicated that all the ICF components and satisfaction with participation influenced the level of QoL in young adults with disabilities in either a direct or indirect manner. CONCLUSIONS: These findings provide evidence that young adults with disabilities have a very complex interaction of their activity participation, social membership, community connectedness, life satisfaction, suggesting that their context of QoL is shaped by how they make sense not only with their functional status, but also the social and community environment. Current findings further demonstrate that the ICF model of functioning and disability should be thought of as multidimensional and more than instrumental in character when being used by health and rehabilitation professionals. IMPLICATIONS FOR REHABILITATION: This study supports the ICF model to include the concept of QoL as the outcome. Rehabilitation practitioners are encouraged to view the ICF model as multidimensional when designing interventions. Social context and support should be included when developing strategies to enhance QoL in youth transition to adulthood.

The impact of mobility on quality of life among older persons.

OBJECTIVE: The purpose of this cross-sectional study was to determine the extent and manner in which mobility is related to quality of life (QOL) in a representative sample of older adults. METHOD: Two models were assessed using structured equation modeling. The first hypothesized that mobility would have a direct effect on QOL along with other variables, including; number of health conditions and satisfaction with functional capacity, life essentials (e.g., transport, access to health services, and conditions of living space) and personal relationships. The second hypothesized that mobility would have its greatest influence on QOL through satisfaction with functional capacity. RESULTS: While both models found that mobility and all three measures of life satisfaction were significantly associated with QOL, goodness of fit indices were higher for the second model. DISCUSSION: The findings from this study suggest that mobility interventions designed to enhance QOL should address satisfaction with functional capacity as well.