Worldwide, there is an increase in ecosystem distress syndromes matched by a corresponding increase in human distress syndromes. The specific role played by global-scale environmental challenges to 'sense of place' and identity will be explored in the future development of the concept of solastalgia.
The study aimed to validate the Environmental Distress Scale (EDS), a new index of the bio-psychosocial cost of ecosystem disturbance. Informed by qualitative fieldwork in the open-cut mining area of AustraliaÕs Upper Hunter Valley, the EDS combines dimensions of hazard perception, threat appraisal, felt impact of changes, ''solastalgia'' (loss of solace), and environmental action. EDS discriminant validity was tested by randomly mailing the instrument to Upper Hunter residents living in a high disturbance open-cut mining areaand to a comparable sample in a nearby farming area; 203 respondents returned the survey (41% response rate).As predicted, the high disturbance group had significantly higher environmental distress scores across all six EDS subscales, including solastalgia. Psychometric analyses found the EDS subscales were highly intercorrelated (r = 0.36-0.83), and they demonstrated both strong internal consistency reliability (CronbachÕs alpha = 0.79-0.96) and test-retest reliability (ICC = 0.67-0.73). Descriptively, the high disturbance group experienced greater exposure to dust, landscape changes, vibrations, loss of flora and fauna, and building damage, as well as greater fear of asthma and other physical illnesses due to local pollution. The EDS successfully measured and validated AlbrechtÕs innovative concept of ''solastalgia''-the sense of distress people experience when valued environments are negatively transformed. While the EDS addresses the power and mining industries, it can be adapted as a general tool to appraise the distress arising from peopleÕs lived experience of the desolation of their home and environment. Ideally, it can be used as an aid for those working to ameliorate that distress and restore ecosystem health.
The Home Falls and Accidents Screening Tool (HOME FAST) was developed as a screening instrument for use in a community preventive care trial for older people. This paper describes the first stage of the development of this screening tool. The objectives of the study were (i) to review existing home safety measures, (ii) to field test an instrument containing a pool of home safety items with the goal of identifying those hazards associated with falls in the home and (iii) to select the items for inclusion in a 25-item tool using an expert panel. The field testing took place in a rural area of Australia, where the pooled checklist was used to evaluate hazards within the homes of 83 older people. No individual hazards were associated with the risk of falls at home and, although participants who had experienced falls had a higher mean number of home hazards (mean = 13.7, SD 8.2), the differences between fallers and non-fallers was not significant. Items relevant to a rural population were indicated through field testing. Further psychometric testing of the HOME FAST and a meaningful method of scoring the checklist are now warranted.
Objective: To assess the effect of home‐based health assessments for older Australians on health‐related quality of life, hospital and nursing home admissions, and death.
Design: Randomised controlled trial of the effect of health assessments over 3 years.
Participants and setting: 1569 community‐living veterans and war widows receiving full benefits from the Department of Veterans’ Affairs and aged 70 years or over were randomly selected in 1997 from 10 regions of New South Wales and Queensland and randomly allocated to receive either usual care (n = 627) or health assessments (n = 942).
Intervention: Annual or 6‐monthly home‐based health assessments by health professionals, with telephone follow‐up, and written report to a nominated general practitioner.
Main outcome measures: Differences in health‐related quality of life, admission to hospital and nursing home, and death over 3 years of follow‐up.
Results: 3‐year follow‐up interviews were conducted for 1031 participants. Intervention‐group participants who remained in the study reported higher quality of life than control‐group participants (difference in Physical Component Summary score, 0.90; 95% CI, 0.05–1.76; difference in Mental Component Summary score, 1.36; 95% CI, 0.40–2.32). There was no significant difference in the probability of hospital admission or death between intervention and control groups over the study period. Significantly more participants in the intervention group were admitted to nursing homes compared with the control group (30 v 7; P < 0.01).
Conclusions: Health assessments for older people may have small positive effects on quality of life for those who remain resident in the community, but do not prevent deaths. Assessments may increase the probability of nursing‐home placement.
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