BackgroundAdvance care planning (ACP) has the potential to increase patient-centred care, reduce caregiver burden, and reduce healthcare costs at the end of life. Current levels of public participation in ACP activities are unknown. The purpose of this study was to determine the level of engagement of average Canadians in ACP activities.MethodsData come from an on-line opinion poll of a national sample of respondents who were asked five questions on ACP activities along with their sociodemographic characteristics.ResultsRespondents were from all provinces of Canada, 52% were women, and 33% were between 45 years and 54 years of age. Of 1021 national sample respondents, 16% were aware of the term, ACP (95% CI 13% to 18%), 52% had discussions with their family or friends (95% CI 49% to 55%), and 10% had discussions with healthcare providers (95% CI 8% to 12%). Overall, 20% (95% CI 18% to 22%) of respondents had a written ACP and 47% (95% CI 44% to 50%) had designated a substitute decision maker. Being older was associated with significantly more engagement in ACP activities and there were significant differences in ACP engagement across Canada.ConclusionsAlthough only a small proportion of Canadians are aware of the formal term, ACP, a higher percentage of Canadians are actually engaged in ACP, through either having discussions or making decisions about end-of-life care. Older citizens are more likely to be engaged in ACP and there are geographic differences in the level of ACP engagement across Canada.
Social network capital reduced the chances of smoking relapse. Smoking cessation programs might aim to increase network diversity so as to prevent relapse.
BackgroundResearch has shown network social capital associated with a range of health behaviours and conditions. Little is known about what social capital inequalities in health represent, and which social factors contribute to such inequalities.MethodsData come from the Montreal Neighbourhood Networks and Healthy Aging Study (n=2707). A position generator was used to collect network data on social capital. Health outcomes included self-reported health (SRH), physical inactivity, and hypertension. Social capital inequalities in low SRH, physical inactivity, and hypertension were decomposed into demographic, socioeconomic, network and psychosocial determinants. The percentage contributions of each in explaining health disparities were calculated.ResultsAcross the three outcomes, higher educational attainment contributed most consistently to explaining social capital inequalities in low SRH (% C=30.8%), physical inactivity (15.9%), and hypertension (51.2%). Social isolation, contributed to physical inactivity (11.7%) and hypertension (18.2%). Sense of control (24.9%) and perceived cohesion (11.5%) contributed to low SRH. Age reduced or increased social capital inequalities in hypertension depending on the age category.ConclusionsInterventions that include strategies to reduce socioeconomic inequalities and increase actual and perceived social connectivity may be most successful in reducing social capital inequalities in health.
With the increase in our older adult population, there is a need for dementia training for informal and formal dementia caregivers. The objective of this scoping study is to assess dementia knowledge instruments utilized in educational programs and interventions intended for formal and informal dementia caregivers. Scoping review methodology was used to search PubMed, PsycInfo, CINAHL and Web of Science with tailored database search terms. The search yielded 8101 results, with 35 studies meeting inclusion. Studies were conducted in eight countries, had varying study designs (randomized controlled trials [RCTs] = 9, non-RCTs = 6, one-group study design = 20) and utilized previously published (19) and author developed (16) instruments. Furthermore, the studies were internationally diverse, conducted in the United States (n = 18), Australia (n = 7), UK (n = 3), China (n = 2), Canada (n = 2), Taiwan (n = 1), Brazil (n = 1) and multi-country (n = 1). Only two studies focused on minority populations. While author-developed instruments may be more relevant and timesaving, studies should strive to validate instruments or use previously published instruments to help standardize findings across studies and understand better the effects of educational programs on caregiver knowledge. Geriatr Gerontol Int 2020; 20: 397-413.
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