Are older adults’ demographic characteristics social determinants of their perceived importance, desire, and ability to perform end‐of‐life self‐care actions?

Tzeng, Huey‐Ming; Barker, Anne; Kang, Yu; Okpalauwaekwe, Udoka; Yin, Chang-Yi

doi:10.1111/nuf.12371

Cited by 2 publications

(2 citation statements)

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“…Others have also found an association between education, income, and diabetes self-care in the US population 15 . Demographic variables such as education, age, and marital status have been found to be associated with not only HF self-care 16 but also self-care actions in end-of-life planning among older adults 17 . To our knowledge, no study author has comprehensively explored the relationship between SDoH broadly defined and HF self-care.…”

Section: Objectivesmentioning

confidence: 99%

“…15 Demographic variables such as education, age, and marital status have been found to be associated with not only HF self-care 16 but also self-care actions in endof-life planning among older adults. 17 To our knowledge, no study author has comprehensively explored the relationship between SDoH broadly defined and HF self-care. Hence, we investigated the relationship between SDoH broadly defined and HF self-care in community-dwelling adults with a recent HF exacerbation by addressing 3 specific aims.…”

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confidence: 99%

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A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure

et al. 2024

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Background The burden of heart failure (HF) is unequally distributed among population groups. Few study authors have described social determinants of health (SDoH) enabling/impeding self-care. Aim The aim of this study was to explore the relationship between SDoH and self-care in patients with HF. Methods Using a convergent mixed-methods design, we assessed SDoH and self-care in 104 patients with HF using the Protocol for Responding to and Assessing Patients' Assets, Risks, and Experiences (PRAPARE) and the Self-Care of HF Index v7.2 with self-care maintenance, symptom perception, and self-care management scales. Multiple regression was used to assess the relationship between SDoH and self-care. One-on-one in-depth interviews were conducted in patients with poor (standardized score ≤ 60, n = 17) or excellent (standardized score ≥ 80, n = 20) self-care maintenance. Quantitative and qualitative results were integrated. Results Participants were predominantly male (57.7%), with a mean age of 62.4 ± 11.6 years, with health insurance (91.4%) and some college education (62%). Half were White (50%), many were married (43%), and most reported adequate income (53%). The money and resources core domain of PRAPARE significantly predicted self-care maintenance (P = .019), and symptom perception (P = .049) trended significantly after adjusting for other PRAPARE core domains (personal characteristics, family and home, and social and emotional health) and comorbidity. Participants discussed social connectedness, health insurance coverage, individual upbringing, and personal experiences as facilitators of self-care behavior. Conclusion Several SDoH influence HF self-care. Patient-specific interventions that address the broader effects of these factors may promote self-care in patients with HF.

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Section: Objectivesmentioning

confidence: 99%

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confidence: 99%

A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure

et al. 2024

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Exploring the Uptake of Advance Care Planning in Older Adults: An Integrative Review

Frechman

Dietrich

Walden

et al. 2020

Journal of Pain and Symptom Management

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Context. Advance care planning (ACP) is essential to elicit goals, values, and preferences of care in older adults with serious illness and on trajectories of frailty. An exploration of ACP uptake in older adults may identify barriers and facilitators. Objective. To conduct an integrative review of research on the uptake of ACP in older adults and create a conceptual model of the findings. Methods. Using Whittemore and Knafl's methodology, we systematically searched four electronic databases of ACP literature in older adults from 1996 through December 2019. Critical appraisal tools were used to assess study quality, and articles were categorized according to level of evidence. Statistical and thematic analysis was then undertaken. Results. Among 1081 studies, 78 met inclusion criteria. Statistical analysis evaluated ACP and variables within the domains of demographics, psychosocial, disability and functioning, and miscellaneous. Thematic analysis identified a central category of enhanced communication, followed by categories of 1) provider role and preparation; 2) patient/family relationship patterns; 3) standardized processes and structured approaches; 4) contextual influences; and 5) missed opportunities. A conceptual model depicted categories and relationships. Conclusions. Enhanced communication and ACP facilitators improve uptake of ACP. Clinicians should be cognizant of these factors. This review provides a guide for clinicians who are considering implementation strategies to facilitate ACP in real-world settings.

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Are older adults’ demographic characteristics social determinants of their perceived importance, desire, and ability to perform end‐of‐life self‐care actions?

Cited by 2 publications

References 25 publications

A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure

A Mixed-Methods Study of Social Determinants and Self-care in Adults With Heart Failure

Exploring the Uptake of Advance Care Planning in Older Adults: An Integrative Review

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