BackgroundTo inform clinical treatment and preventative efforts, there is an important need to understand the pathways to late-life gambling disorder.AimsThis study assesses the association between age-related physical health, social networks, and problem gambling in adults aged over 65 years and assesses the mediating role of affective disorders in this association.MethodsThe sample comprised 595 older adults (mean age: 74.4 years, range: 65–94 years; 77.1% female) who were interviewed using a structured questionnaire to assess physical frailty, geriatric pain, loneliness, geriatric depression, geriatric anxiety, and problem gambling.ResultsPathway analysis demonstrated associations between these variables and gambling problems, providing a good fit for the data, but that critically these relationships were mediated by both anxiety and depression symptoms.ConclusionsThis study indicates that late-life problem gambling may develop as vulnerable individuals gamble to escape anxiety and depression consequent to deteriorating physical well-being and social support. When individuals develop late-life problem gambling, it is recommended that the treatment primarily focuses upon targeting and replacing avoidant coping approaches.
The prevalence of older adult female gambling participation and gambling disorder is increasing in the UK, and there is a paucity of published research available to understand possible risk factors for frequent gambling in this demographic. The aim of the current study was to identify and explore motivations and patterns of gambling behavior in high-frequency older adult female gamblers in the UK, from the perspective of the individual and in the context of their experience of aging. Ten UK older adult female high-frequency gamblers were recruited via stratified purposive sampling, with a mean age of 70.4 years. Data was collected via semistructured interviews and analyzed using interpretative phenomenological analysis. Three core themes representative of the experience of this phenomenon emerged from the transcripts, including: Filling voids, emotional escape, and overspending. The present study has provided a contextualized understanding of motivating factors and several age-related vulnerabilities that may account for high gambling frequency in this population.
ObjectivesInternational medical graduates (IMGs) perform less well in national postgraduate licensing examinations compared with UK graduates, even in computer-marked multiple-choice licensing examinations. We aimed to investigate thought processes of candidates answering multiple- choice questions, considering possible reasons for differential attainment between IMGs and UK graduates.DesignWe employed a semistructured qualitative design using cognitive interviews. Systematic grounded theory was used to analyse data from ‘think aloud’ interviews of general practitioner specialty trainees (GPSTs) while answering up to 15 live questions from the UK Membership of the Royal College of General Practitioners Applied Knowledge Test (AKT).SettingEast Midlands, UK.Participants21 GPSTs including 13IMGs and 8 UK-trained doctors.OutcomesPerceptions of participants on how they answered AKT questions together with strategies used or difficulties experienced.ResultsWe interviewed 21 GPSTs (8 female, 13 male, 13 IMGs, 14 from black and minority ethnic groups, age 24–64 years) in years 1–3 of training between January and April 2017. Four themes were identified. ‘Theoretical versus real-life clinical experience’: participants reported difficulties recalling information and responding to questions from theoretical learning compared with clinical exposure; rote learning helped some IMGs recall rare disease patterns. Recency, frequency, opportunity and relevance: participants reported greater difficulty answering questions not recently studied, less frequently encountered or perceived as less relevant. Competence versus insight: some participants were over optimistic about their performance despite answering incorrectly. Cultural barriers: for IMGs included differences in undergraduate experience, lack of familiarity with UK guidelines and language barriers which overlapped with the other themes.ConclusionsThe difficulties we identified in candidates when answering AKT questions may be addressed through training. IMGs face additional difficulties which impede examination success due to differences in educational experience, content familiarity and language, which are also potentially amenable to additional training support.
Gambling participation among older adults aged 65 and above has increased in Great Britain. However, there is limited research and therefore understanding about cognitive and behavioural patterns of gambling for this demographic. The objective of this study is to develop a substantive framework that represents the gambling behaviour of older adults in Great Britain, with specific reference to motivational factors affecting behaviour. A systematic grounded theory approach (Strauss & Corbin, 1998) was used to produce an inductive set of theoretical propositions. A stratified sample of 17 British older adults aged 65 years and older, who gambled frequently, was recruited. Theoretical sampling was used to fully develop emerging concepts. Axial and selective coding revealed that gambling was often used as a coping mechanism to alleviate distress from psychological and physical lifestyle changes associated with the aging process. In total, four grounded theoretical propositions emerged that accounted for gambling participation, including facilitation of gambling, psychological stress reduction, physical stress mediation, and satisfaction of stimulation needs. Patterns emerged from the data that suggested unique motivational factors regarding gambling behaviour of older adults in Great Britain in contrast to other adult populations. This is the first study to investigate gambling behaviour in British older adults. New directions for future research are discussed in relation to emergent findings.Une augmentation de la participation des personnes âgées de 65 ans et plus au jeu a été observée en Grande-Bretagne. Il existe toutefois peu d’études sur le sujet et, par conséquent, on connaît peu les caractéristiques cognitives et comportementales de ce groupe de la population en ce qui a trait au jeu. La présente étude vise à concevoir un important cadre de travail représentant le comportement de jeu des personnes âgées en G.-B., faisant explicitement référence aux facteurs qui motivent le comportement. On a utilisé la méthode de la théorie ancrée (systematic grounded theory) (Strauss & Corbin, 1998) pour produire un ensemble inductif de propositions théoriques. Un échantillon stratifié de 17 Britanniques âgés de 65 ans et plus s’adonnant souvent au jeu a été formé. L’échantillonnage théorique a servi à élaborer de nouveaux concepts. Le codage axial et sélectif des données a révélé que le jeu était souvent employé comme mécanisme d’adaptation pour atténuer la détresse découlant des changements psychologiques et physiques du mode de vie associés au processus de vieillissement. Au total, quatre propositions de théorie ancrée ont émergé pour expliquer la participation au jeu : la facilitation du jeu, la réduction du stress psychologique, la médiation du stress physique et la satisfaction des besoins de stimulation. Les caractéristiques émergeant des données laissent entendre que par rapport à d’autres populations de personnes âgées, il y aurait des facteurs motivationnels uniques au comportement de jeu des personnes âgées en G.-B. Cette étude est la première à se pencher sur le comportement de jeu des personnes âgées britanniques et à discuter des nouvelles orientations à donner aux études futures compte tenu des conclusions qui y sont énoncées.
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