OLDER COMMUNITY-DWELLING ADULTS ATTITUDES TOWARD AND PRACTICES OF HEALTH PROMOTION AND ADVANCE PLANNING ACTIVITIES
OLDER COMMUNITY-DWELLING ADULTS ATTITUDES TOWARD AND PRACTICES OF HEALTH PROMOTION AND ADVANCE PLANNING ACTIVITIES
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DOI：
10.1111/j.1532-5415.1995.tb07199.x
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发表时间：
1995-06-01
影响因子：
6.3
通讯作者：
LIPSITZ, LA
中科院分区：
文献类型：
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作者：
FRIED, TR;ROSENBERG, RR;LIPSITZ, LA
目的：描述一群社区居住的老年人对健康预防和提前计划措施的态度和实践，并研究年龄对这些实践的影响。设计：通过邮件调查进行描述性研究。参与者：65岁或以上的研究注册者。测量方法：通过书面问卷，我们询问了各种健康预防和预先计划主题的知识，包括运动、胆固醇筛查、直肠检查、流感疫苗接种、乙状结肠镜检查、乳房x光检查、前列腺癌筛查、器官捐赠、尸检、医疗代理和预先指示。在那些知道这个话题的人中，我们询问被调查者是否与医生讨论过这个话题，是谁发起的谈话，以及被调查者是否参加了这个活动。我们还询问了这个话题对受访者的重要性。结果：共收到问卷598份，回复率83%。受访者平均年龄为74岁，主要是白人（96%），受过良好教育，其中44%完成了大学学业。受访者对这些主题都很了解，除了乙状结肠镜检查、器官捐赠和尸检外，超过70%的人认为这些主题很重要。就健康检查和预防活动而言，很大比例的答复者报告曾与医生讨论过这一主题，而报告定期参与的比例略小。然而，在医疗代理和预先指示的情况下，只有大约一半做出这些安排的人说他们与医生讨论过这些安排。当讨论确实发生时，它更有可能是由答辩人发起的。在控制教育水平的情况下，年龄与女性报告接受乳房x光检查的可能性呈负相关（P < 0.05）。然而，年龄与接受其他筛查试验的频率降低无关。结论：在受过良好教育的老年人群体中，对健康筛查、健康促进和提前计划活动的兴趣和依从性较高。然而，乙状结肠镜检查是一种侵入性相对较大的检查方法，通常被推荐作为一种筛查工具，但据报道，与前列腺癌筛查相比，乙状结肠镜检查的实施可能性较小，前列腺癌筛查是一种侵入性较小的检查方法，但没有这种推荐。老年人表示，他们正在寻求医疗代理和预先指示，往往没有他们的医生参与。在我们询问的筛查测试中，年龄只与乳房x光检查的频率较低有关。
OBJECTIVE: To describe the attitudes toward and practice of health prevention and advance planning measures by a group of community-dwelling older adults and to examine the effect of age on these practices.DESIGN: A descriptive study performed by mail survey.PARTICIPANTS: Members of a research registry who were 65 years of age or older.MEASUREMENTS: By means of a written questionnaire, we asked about knowledge of various health prevention and advance planning topics, including exercise, cholesterol screening, rectal examination, influenza vaccination, sigmoidoscopy, mammography, prostate cancer screening, organ donation, autopsy, health care proxy, and advance directives. Of those who knew about the topic, we asked if the respondent had discussed it with a physician, who initiated the conversation, and if the respondent participated in the activity. We also asked how important the topic was to the respondent.RESULTS: We received 598 completed surveys, a response rate of 83%. Respondents had a mean age of 74 years, were predominately white (96%), and were well educated, with 44% having completed college. The respondents were all knowledgeable about the topics, and, with the exception of sigmoidoscopy, organ donation, and autopsy, more than 70% thought these topics were important. In the case of health screening and prevention activities, a large percentage of respondents reported having discussed the topic with a physician, and a slightly smaller percentage reported regular participation. In the case of health care proxies and advance directives, however, only about one-half of those who had made these arrangements said they had discussed them with a physician. When discussion did occur, it was much more likely to have been initiated by the respondent. Controlling for level of education, age was inversely associated with the likelihood of a woman reporting she had undergone mammography (P < .05). Age, however, was not associated with decreased frequency of undergoing other screening tests.CONCLUSIONS: Among a group of well educated older adults, reported interest in and compliance with health screening, health promotion, and advance planning activities were high. However, sigmoidoscopy, a relatively more invasive procedure that is generally recommended as a screening tool, is reported less likely to be practiced than prostate cancer screening, a less invasive procedure without such recommendation. Older adults state they are pursuing health care proxies and advance directives, often without the involvement of their physicians. Of the screening tests about which we asked, age was associated only with less frequent practice of mammography.