The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 specifically encourages Medicare enrollees to use the Internet to obtain information regarding the new prescription drug insurance plans and to enroll in a plan. This reliance on computer technology and the Internet leads to practical questions regarding implementation of the insurance coverage. For example, it seems unlikely that all Medicare enrollees have access to computers and the Internet or that they are all computer literate. This study uses the 2003 Current Population Survey to examine the effects of disability and income on computer access and Internet use among the elderly. Internet access declines with age and is exacerbated by disabilities. Also, decreases in income lead to decreases in computer ownership and use. Therefore, providing prescription drug coverage primarily through the Internet seems likely to maintain or increase stratification of access to health care, especially for low-income, disabled elderly, who are also a group most in need of health care access.
This study underscores that cardiac patients across a variety of diagnoses and comorbidities often experience sexual concerns, fears, symptoms, and dysfunction. The strongest predictors of sexual concerns were the number of cardiac and noncardiac comorbidities, thus illustrating the importance of a thorough assessment of these factors when examining sexual concerns of cardiac patients.
The psychological impact of a cardiac event includes anxiety and depression, poor sexual quality, and diminished sexual satisfaction. Few measures capture psychosexual recovery following a cardiac event. This study evaluated the reliability and validity of the Sexual Self-Perception and Adjustment Questionnaire (SSPAQ) among cardiac patients (N ¼ 128), measuring sexual anxiety, depression, self-efficacy, and satisfaction. Scale-level content validity was 0.97. After item analysis, 28 items were retained; Cronbach's alpha is >0.90, indicating item appropriateness for the combined scale (0.97). A four-factor model was supported with each of the subscale items accounting for at least 64% of the variance. Construct validity comparing sexually active to inactive showed those inactive had significantly lower sexual self-perception. The SSPAQ is a cohesive measure of sexual self-perception, and findings suggest each subscale can be used independently for measures of sexual anxiety, sexual depression, sexual self-efficacy, and sexual satisfaction, and may be useful in research and clinical settings.
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