Search results

In Israel, institution staff classify residents’ functional status as part of the routine governmental surveillance of institutions for semi‐independent and frail elderly. However, owing to a lack of clarity and specificity in the regulation which defines functional status categories, nurse surveyors, who conduct the routine surveillance of institutions, have begun to make their own estimates of functional status. Data were collected and compared on the functional status classification of 78 per cent of the elderly residents by institution staff and nurse surveyors. Data analysis showed that the poorer the functional status, the less congruity between the classifications. This has practical consequences for estimating the number and type of staff needed. It was found that the waste of resources and discrepancies caused by reclassification of the elderly by the nurse surveyors may be avoided by using more specific and precise definitions as suggested in this article.

Reports a study of managerial stress and its dependence on the functional area of the manager. Nine stressors were identified through (a) a literature search and (b) interviews with managers of the different functional areas as well as with academicians as being “functionally dependent”. Data were obtained from questionnaires completed by 128 managers. Analysis revealed that eight of the nine stressors (role ambiguity, pressure for performance, travel as part of the job, being on the interface, responsibility for people, responsibility for things, status of the functional area, and crisis situations) were dependent on the functional area and not on age of the manager, hierarchical level or tenure in the organization. Discusses the managerial and organizational implications.

Motivated by research linking job autonomy and job creativity with psychological well-being, this study examines how these work characteristics influence well-being among people with and without physical disabilities, utilizing both a categorical and continuous measure of disability.

Data were drawn from two waves of a community study in Miami-Dade County, Florida, of 1,473 respondents. Structural equation modeling was used to assess whether job autonomy and job creativity mediate the associations between the indicators of physical disability considered and depressive symptoms and whether these associations varied by gender.

Controlling for the effects of the sociodemographic control variables, both job autonomy and job creativity significantly influence the association between physical disability and depressive symptoms regardless of the measure of disability used. The effects of job autonomy were significantly greater for women than men in the context of greater functional limitation.

The findings highlight the need to further consider the work characteristics of employed people with disabilities. They also demonstrate that the conceptualization and measurement of physical disability has important research implications.

The purpose of this study is to explore the relationship between nutritional status and associated risk factors such as:, socio-economic, physical, pathological and psychological factors, among elderly residing in Lebanese nursing homes.

This cross-sectional study was carried out in 36 elderly care nursing homes with 2,094 residents. Of these, only 221 (11 per cent) elderly met the inclusion criteria and successfully completed the interview question. Data on socio-demographic characteristics and health conditions: oral, nutritional, depression, chronic diseases and activities of daily living, were collected. The analysis used a chi-square test and a binary logistic regression.

High levels of malnourishment were found among elderly who had no jobs (p = 0.012) and had oral health problems (p = 0.038), functional impairment (p < 0.001) and depression (p = 0.021). Comorbid illnesses, however, had no significant association with nutritional status. In addition, the first and strongest predictor entered in the regression on malnutrition was functional impairment (p = 0.002) followed by oral health problems (p = 0.030) and depression (p = 0.036).

The study is original in the sense that it emphasized the importance of three factors, autonomy, better oral and psychological health, in mediating nutritional outcomes for elderly residing in nursing homes.

Using data from the Survey of Income and Program Participation (SIPP) matched to administrative records, we examine mortality risk and participation in the Disability Insurance (DI) and Supplemental Security Income (SSI) disability programs from a long-term perspective. Over a period of 14 years, we analyze the effect of self-reported health and disability on the probability of death and disability program entry among individuals aged 18–48 in 1984. We also assess DI and SSI programs from a life-cycle perspective. Self-reported poor health and severe disability at baseline are strongly correlated with death over the 14-year follow-up period. These variables also are strong predictors of disability program participation over the follow-up period among non-participants at baseline or before, with increasing marginal probabilities in the out-years. Our cross-sectional models are consistent with recent studies that find that the work-prevented measure is useful in modeling DI entry. However, once self-reported health and functional limitations are accounted for, the longitudinal entry models provide conflicting DI results for the work-prevented measure, suggesting that, contrary to claims based on cross-sectional or short-time horizon application models, the work-prevented measure is an unreliable indicator of severity. The risk of SSI and DI participation is significantly greater for individuals who die, suggesting that future mortality captures the effect of case severity and deterioration of health during the follow-up period. From a life-cycle perspective, a substantially greater proportion of individuals participate in SSI or DI at some point in their lives compared to typical cross-sectional estimates of participation, especially among minorities, people with less than a high school education, and those with early onset of poor health and/or disabilities. Cross-sectional estimates for the Social Security area population indicate SSI and DI participation rates of no more than 5% combined in 2000. In contrast, for individuals aged 43–48 in 1984, we observe a cumulative lifetime SSI and/or DI participation rate of 14%. The corresponding figure is 32% for individuals in that age group who did not graduate from high school, suggesting the need for human capital investments and/or improved work incentives.

The objective of this chapter was to advance the medical sociology theoretical literature on health lifestyle behaviors. This study investigated the influence of mid-life adult statuses (gender, marital status, parenthood, presence of children in the home, and employment status) and functional health status (general physical health, general mental health, vitality, and social functioning) on selected health-related behaviors. These behaviors included preventive medicine behaviors (routine physical exams, cholesterol checks, and blood pressure checks), risk-taking behaviors (driving above the speed limit, smoking, and consuming alcohol), health promoting behaviors (exercising, sleeping well, and relaxing), and medication usage (using prescribed medicines, over-the-counter medicines, and herbal supplements). The data were gathered through the Warren County Health Survey, a telephone survey of a randomly selected sample of residents from a county in Kentucky. Logistic regression was used to analyze the data. Results indicated that having children at home, being married, being fifty years old or older, and possessing better mental health and social functioning statuses were associated with a greater likelihood of practicing better health-related behaviors. In contrast, being both male and aged 49 and younger were correlated with a greater likelihood of engaging in poorer health-related behaviors. Based on these results, the authors offered several testable, theoretical propositions for future research to test the relationships between mid-life adult health statuses, functional health statuses, and health-related behaviors in other community-based samples.

The paper aims to investigate if the performance of older adults on the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) were associated or predictive of their functional performance in a geriatric evaluation and management (GEM) inpatient hospital setting. This will inform the occupational therapy assessment and management of older adults admitted to sub-acute GEM settings.

In all, 20 participants (11 men, 9 women, mean age 82 years, SD = 6.93) were recruited from a GEM ward in an Australian hospital. Participants’ cognitive abilities were assessed using the MMSE and MoCA, and their functional performance were assessed using the Functional Independence Measure (FIM). Spearman’s rho correlations and linear regression analyses were completed. Bootstrapping was applied to the regression analyses to accommodate the small study sample size.

No statistically significant correlations were obtained between the total and subscale scores of the MMSE and FIM or between the total and subscale scores of the MoCA and FIM. In other words, the cognitive and functional abilities of older adults admitted to a GEM setting were not significantly associated in this study.

The findings suggest that the MoCA and the MMSE were not predictive of participants’ functional performance as measure by the FIM in a sub-acute GEM setting. Occupational therapists should be cautious when interpreting participants’ MMSE, MoCA and FIM results and not depend solely on these results in the goal setting and intervention planning processes for clients on GEM wards. Further studies are recommended to confirm these findings.

The purpose of this paper is to reacquaint us with Chester Barnard's seminal treatise on status systems in organizations – the conceptualization that he labeled as a “missing scroll” of The Functions of the Executive.

The paper analyzes this “missing scroll” to draw the parallels and distinctions between Barnard's and the contemporary views of status systems in organization.

The paper outlines how this forgotten piece can inform and enrich the current understanding of the role of status in organization theory.

This paper draws practical parallels and distinctions between Barnard's and the contemporary views of status systems in organization and management literature.

This paper corrects the omission from The Functions of the Executive showing that Barnard was the first to recognize status systems as systematic in organizations.

Understanding the determinants of health services use is essential for planning for effective services, particularly health care policies in a newly independent state, the Republic of Kazakhstan. The main purpose of this study is to examine the relative importance of social capital factors in affecting the variation in health status and use of health services, using structural equation modeling. The results show that health status is a strong predictor of health services use when the effect of social capital is held constant; and that social capital is directly linked with health status.

The paper reports on the implementation of the Revised Elderly Persons' Disability Scale use – a 53‐item, seven sub‐scale functional assessment tool – in a range of older adult care institutions. Staff education on the instrument's use is provided; patient assessments collated centrally; and results fed back to respective care facilities. This study explores the views of qualified and unqualified staff on the use of the scale in their respective UK National Health Service, Local Authority or Private Residential older adult care facilities.

An action research mode was adopted where the researcher was a member of a team responsible for planning, development, and co‐ordination of community care projects for adults leaving hospital care. Structured and semi‐structured interviewing was employed to explore personal experience of the instrument's use in older adult care institutions. A total of 20 care staff qualified in nursing or social work and nine unqualified staff participated in this research.

Participants reported that scale use contributed positively to the planning and delivery of care. Its use influenced the admission of individuals for care by the institutions studied and improvements in the quality of the transfer of clients between settings were reported. It proved straightforward to use and unqualified staff reported their greater involvement in the care planning process as a result of its implementation. Participants reported that instrument use contributed to the identification of staff training needs.

Evidence for functional assessment scale effectiveness is equivocal and little has been published on the experience of scale use by a range of elder care staff. This experience forms this study's sole focus and scale use is shown to have the potential to contribute to care improvement.