Kim-Michelle Gilson

A prospective study of the impact of floods on the mental and physical health of older adults.

Objectives: With a longitudinal prospective design, we examined the impact of floods on the mental and physical health of older adults and explored risk and protective factors. Method: Two hundred and seventy four older adults (age ≥60) completed surveys before and after a flood event. Both the surveys included measures of anxiety, depression, self-reported health, and satisfaction with life; the post-flood survey also included questionnaires on flood experience, symptoms of post-traumatic stress disorder (PTSD), stoicism, and psychological coping with floods. Results: Compared to those not personally affected (78.8%), personally affected individuals (21.2%) reported significantly higher PTSD symptoms, with about one in six reporting PTSD symptoms that might require clinical attention. Personally affected individuals also reported a greater increase in anxiety post-flood, but changes in their depressive symptoms and self-reported health were not significantly different from those not personally affected. Greater flood exposure and the lack of social support were the risk factors for poorer mental and physical health. Higher stoicism was associated with higher post-flood depression and poorer self-reported mental health. The use of maladaptive coping, such as venting and distraction, was associated with greater deterioration in mental health after floods, whilst emotion-focused coping such as acceptance, positive reframing, and humour, was protective against such deterioration. Conclusion: Floods had adverse psychological impacts on some older adults who were personally affected. Despite the evidence of resilience, a small proportion of older adults experienced significant difficulties after the floods. The findings in this study help understand older adults’ psychological responses to disasters and have practical implications for service planning and delivery.

Antecedents of Attitudes to Aging: A Study of the Roles of Personality and Well-being

PURPOSE OF THE STUDY Little research has examined factors that contribute to the formation of attitudes toward ones own aging. The current study aimed to examine personality as defined by the Five-Factor model of personality as an antecedent of attitudes, while taking into account demographic and health factors known to be relevant to such attitudes. DESIGN AND METHODS Participants aged 60 years or older (N = 421) were part of a longitudinal study of health and well-being in Australia, and completed a postal survey comprising measures of personality, the Attitudes to Ageing Questionnaire, the SF-12 health survey, and the Satisfaction with Life Scale. RESULTS Higher levels of neuroticism were associated with less positive attitudes toward old age as a time of psychological growth, and higher extraversion and agreeableness were significant predictors of less negative attitudes toward psychosocial loss. Baseline measures of self-reported mental and physical health, as well as change in those scores, also made significant contributions to attitudes toward aging. IMPLICATIONS Personality was a significant antecedent of attitudes towards aging, as were mental and physical health. The data highlight the role of potentially modifiable factors, such as mental and physical health. If these factors act as resources that shape an individuals attitudes during the aging process, then one potential foundation for holding positive attitudes to aging is to maintain physical and mental health. This requires interventions and policies that are effective in encouraging health-promoting behaviors.

Quality of Life in Children With Cerebral Palsy Implications for Practice

The ability to assess the quality of life of children with cerebral palsy to inform and evaluate individual care plans, service planning, interventions, and policies is crucial. In this article, the recent evidence on quality of life in children with cerebral palsy is reviewed, with attention to the determinants of quality of life and role of this construct as a practical outcome indicator in clinical trials. Quality of life measurement advances for children with cerebral palsy are discussed with a focus on condition-specific quality of life measures, particularly, the Cerebral Palsy Quality of Life–Child, which is the first condition-specific quality of life measure for children with cerebral palsy. The article presents an overview for clinicians and researchers intending to use quality of life measures on children with cerebral palsy and provides recommendations for future research that will better inform practice in the field.

Exploring Risky Drinking and Knowledge of Safe Drinking Guidelines in Older Adults

Background: Risky drinking criteria in older adults lack consistency across the literature. The variable definitions of risk have contributed in part, to widely differing prevalence estimates for risky drinking, ranging from 1% to 15%. Objectives: (1) To identify the prevalence of different types of risky drinking by applying several different criteria, (2) To investigate whether older adults have knowledge of the National Health and Medical Research Council recommended guidelines for safe drinking. Methods: The study population consisted of community dwelling past-year drinkers (n = 292) aged ≥60 years. Participants completed a postal survey on alcohol consumption using the AUDIT-C. Results: Applying multiple risky drinking criteria indicated that 6.6% to 31.7% of women and 21.6% to 44.8% of men were risky drinkers. Men were more likely than women to have inaccurate knowledge of the NHMRC guidelines, and nearly 59.2% of men who exceeded 14 drinks per week reported either not knowing the recommended limits or reported limits that exceeded the guidelines. Conclusions/Importance: A substantial number of older men drank at risky levels and overestimated safe drinking limits. Greater education on the vulnerability to alcohol-related harm together with greater screening practice by health professionals and service providers is recommended. Findings illustrate how different risky drinking criteria vary in their average AUDIT-C scores, with the NHMRC criteria showing greater average scores compared to other criteria. Results also imply that cutoff scores of ≥4 for women and ≥6 for men are consistent with a range of risky drinking criteria in older adults.

Validation and utility of the Attitudes to Ageing Questionnaire: Links to menopause and well-being trajectories

OBJECTIVES Qualitative studies show that women link menopause to the ageing process, and yet surprisingly little research has investigated how attitudes to ageing might shape womens experience of menopause, as well as their overall well-being at midlife. This study validated the Attitudes to Ageing Questionnaire (AAQ) for use among midlife women, and explored the AAQs role in predicting menopausal factors and 10 year well-being trajectories in the midlife group. STUDY DESIGN Scale validation involved cross-sectional group comparisons of the AAQ factor structure between a sample of midlife women aged 40-60 (n=517) and sample of women aged over 60 (n=259). Longitudinal data on 10-year change in subjective well-being was analysed for a subsample of the midlife group (n=492). MAIN OUTCOME MEASURES Hot flush interference ratings, menopausal beliefs, subjective well-being. RESULTS Assessment of measurement invariance showed support for configural and scalar invariance, with partial support for strict invariance. Midlife women exhibited more negative attitudes to ageing on the psychosocial loss subscale compared to older women. Attitude to psychosocial loss was the strongest predictor of womens experience of menopause, and women with a negative attitude to psychosocial loss did not experience gains in subjective well-being with age that were characteristic of those with a positive attitude. CONCLUSIONS Findings demonstrate the validity and utility of the AAQ for use among midlife women. Policies to enhance attitudes to ageing could be beneficial to protect well-being during the second half of life.

The hidden harms of using alcohol for pain relief in older adults.

Estimates from population-based studies indicate that older adults drink more frequently than younger age groups. Data from the 2010 Australian national household survey reported that daily drinking was evident in 13.3% of older adults aged 60–69 years and in 14.8% of older adults aged 70+ years. These findings are compared to daily drinking rates reported by 10.1% of adults aged 50–59 years and 7.5% in the 40–49 years age range (Australian Institute of Health and Welfare, 2011). The study of alcohol consumption in older adults is particularly important because of their increased sensitivity to alcohol-related harms. With age, the bodys ability to process alcohol decreases as a result of physiological changes, such as decreases in body mass and higher levels of fatty tissue, leading to a higher blood alcohol concentration for a given dose compared with younger adults (National Institute on Alcohol Abuse and Alcoholism, 1998). This greater vulnerability to the effects of alcohol necessitates a stronger understanding of drinking practices in older adults.

Understanding older problem drinkers: The role of drinking to cope.

INTRODUCTION AND AIMS Despite a common perception that older adults drink less than younger adults, drinking frequency increases with age. The aim of this study was to examine the types of coping motives associated with problem drinkers in addition to the types of specific drinking problems most commonly endorsed by older drinkers. The study also sought to investigate the role of individual drinking to cope motives in problem drinking. METHOD Participants were 288 community dwelling older adults aged who consumed alcohol, and were drawn from a larger study of health and aging in rural areas of Australia. Participants completed a postal questionnaire comprising the Drinking Problems Index, Drinking Motives Questionnaire, The AUDIT-C, and the Centre for Epidemiological Studies Depression Scale. RESULTS Overall, 22.2% of the sample were problem drinkers, with a higher prevalence for men (30.4%) than women (15.6%). Problem drinkers were significantly more likely to consume alcohol according to several indices of risky drinking. The most common drinking problems experienced were becoming intoxicated, spending too much money on drinking, feeling confused after drinking, and skipping meals. Drinking to cope motives to relax, to manage physical symptoms and to feel more self-confident increased the odds of problem drinking. CONCLUSIONS Problem drinking is highly prevalent in older adults. Given the potential adverse consequences of problem drinking on the health of older adults it is imperative that health professionals pay attention to drinking behaviours as part of routine practice.

A rights-based approach for service providers to measure the quality of life of children with a disability

BACKGROUND This paper identifies the best instruments for service providers to measure the quality of life (QoL) of children with a disability, with a focus on their alignment with the Convention on the Rights of Persons with a Disability (CRPD). METHODS This study reviewed systematic reviews to identify generic QoL instruments for children and adolescents, followed by an appraisal process using newly developed criteria. QoL instruments with a health status, functioning, and condition-specific focus were excluded. RESULTS Twenty generic QoL instruments for children were identified from existing systematic reviews to undergo further review. Only 2 of the 20 instruments were recommended for service providers to measure the QoL of children with a disability (KIDSCREEN and KINDL). Many pediatric QoL instruments (N = 9) focus on functioning and are not consistent with the CRPD, confounding a childs functioning with their feelings about their life. KIDSCREEN and KINDL have self-report and parent report versions, are applicable for childhood and adolescence, demonstrate adequate reliability and validity, involved children in their development, focus on wellbeing, are likely to be able to be completed by a child with a disability, and are low in cost. CONCLUSIONS Many instruments focus on functioning rather than wellbeing and thus may not capture the QoL of children with a disability. A childs functional limitations may not be consistent with their feelings about life. Two instruments that assess wellbeing and meet the criteria important for service providers now require further testing to explore their usefulness and validity for children with varying abilities.

Enhancing support for the mental wellbeing of parents of children with a disability: Developing a resource based on the perspectives of parents and professionals

ABSTRACT Background: Raising a child with a disability can place significant strain on the mental wellbeing of parents and carers. This study developed a mental wellbeing resource specifically for parents and carers of children and adolescents with a disability. Methods: Interviews with 20 parents and carers and 13 health and disability service professionals were conducted to determine resource content and format. Results: Key information areas for the resource were information about parent/carer wellbeing; understanding the barriers to wellbeing, including lack of support, being unable to ask for help, being isolated from the community, and having insufficient time or income to spend on self; suggestions on how to organise respite; and opportunities for increasing wellbeing. Conclusions: Given parental mental health is key to the quality of life of the child and family, it is recommended that the resource is distributed to parents and professionals, and adapted for different cultural and linguistic backgrounds.