| 1. |
- Ahmed, Syed Masud, et al.
(författare)
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Targeted intervention for the ultra poor in rural Bangladesh: Does it make any difference in their health-seeking behaviour?
- 2006
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Ingår i: Social Science & Medicine. - : Elsevier BV. - 0277-9536. ; 63:11, s. 2899-2911
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Tidskriftsartikel (refereegranskat)abstract
- It is now well recognised that regular microcredit intervention is not enough to effectively reach the ultra poor in rural Bangladesh, in fact it actively excludes them for structural reasons. A grants-based integrated intervention was developed (with health inputs to mitigate the income-erosion effect of illness) to examine whether such a targeted intervention could change the health-seeking behaviour of the ultra-poor towards greater use of health services and "formal allopathic" providers during illness, besides improving their poverty status and capacity for health expenditure. The study was carried out in three northern districts of Bangladesh with high density of ultra poor households, using a pre-test/post-test control group design. A pre-intervention baseline (2189 interventions and 2134 controls) survey was undertaken in 2002 followed by an intervention (of 18 months duration) and a post-intervention follow-up survey of the same households in 2004. Structured interviews were conducted to elicit information on health-seeking behaviour of household members. Findings reveal an overall change in health-seeking behaviour in the study population, but the intervention reduced self-care by 7 percentage units and increased formal allopathic care by 9 percentage units. The intervention increased the proportion of non-deficit households by 43 percentage units, as well as the capacity to spend more than Tk. 25 for treatment of illness during the reference period by 11 percentage units. Higher health expenditure and time (pre- to -post-intervention period) was associated with increased use of health care from formal allopathic providers. However, gender differences in health-seeking and health-expenditure disfavouring women were also noted. The programmatic implications of these findings are discussed in the context of improving the ability of health systems to reach the ultra poor.
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| 2. |
- Biliunaite, Ieva, 1992-
(författare)
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Care for the Caregiver : Internet intervention for informal caregivers in Lithuania
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Informal caregivers are individuals who provide care for significant others in need of support due to frailty or illness. Being able to support a family member can be a very rewarding but at the same time a demanding task. Consequently, informal caregivers are known to experience not only positive but also negative psychological health outcomes and should be offered appropriate support. The main goal of this thesis was to evaluate if Internet-based Cognitive Behavioural Therapy (ICBT) can be suited to provide Lithuanian informal caregivers with psychological support. In addition, a secondary aim was to collect information regarding Lithuanian informal caregiver characteristics, their experienced burden and support needs.The results showed that Lithuanian informal caregivers experience unmet support needs and a high caregiver burden. The findings also show that ICBT can be an effective and acceptable support option for Lithuanian informal caregivers in reducing their burden, depression, anxiety, stress and increasing the perceived quality of life. In conclusion, ICBT should be considered a promising psychological support option for Lithuanian informal caregivers. Further research is needed to evaluate the suitability of ICBT in regular care.
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| 3. |
- Biswas, Priti, et al.
(författare)
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Dynamics of Health Care Seeking Behaviourof Elderly People in Rural Bangladesh
- 2006
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Ingår i: International Journal of Ageing and Later Life. - 1652-8670. ; 1:1, s. 69-89
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Tidskriftsartikel (refereegranskat)abstract
- Bangladesh is projected to experience a doubling of its elderly populationfrom the current level of 7 million to 14 million by the end of the nextdecade. Drawing upon qualitative evidence from rural Bangladesh, thisarticle focuses on coping strategies in cases of illness of elderly peopleand the contributing factors in determining the health-seeking behaviourof elderly persons. The sample for this study consisted of elderly menand women aged 60 years or older and their caregivers. Nine focus groupdiscussions and 30 in-depth interviews were conducted. Findingsindicate that old age and ill-health are perceived to be inseparableentities. Seeking health care from a formally qualified doctor is avoideddue to high costs. Familiarity and accessibility of health care providersplay important roles in health-seeking behaviour of elderly persons.Flexibility of health care providers in receiving payment is a crucialdeciding factor of whether or not to seek treatment, and even the type oftreatment sought.
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| 4. |
- Bostrom, Anne-Marie, et al.
(författare)
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Factors in the psychosocial work environment of staff are associated with satisfaction with care among older persons receiving home care services
- 2022
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Ingår i: Health & Social Care in the Community. - : John Wiley & Sons. - 0966-0410 .- 1365-2524. ; 30:6, s. e6080-e6090
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Tidskriftsartikel (refereegranskat)abstract
- Older persons in Sweden are increasingly encouraged to continue living at home and, if necessary, be supported by home care services (HCS). Studies have examined whether the work environment of staff has an impact on the experiences and well-being of older persons in residential care facilities, but few have examined such associations in HCS. This study examined associations between home care staff's perceptions of their psychosocial work environment and satisfaction with care among older people receiving HCS. The setting was 16 HCS work units. Two surveys were conducted, one on psychosocial working conditions of staff, one on satisfaction of older persons receiving HCS. For each work unit, data on individual satisfaction were matched to average values concerning psychosocial work conditions. Outcomes analysed with linear regressions were overall satisfaction and indices regarding assessment of performance of services, contact with staff and sense of security. The index for treatment by staff was analysed with ordered logistic regressions. Cluster correlated-standard error clustering on work units was used. Results showed that good working conditions were important for satisfaction with care, specifically overall satisfaction, treatment by staff and sense of security. The most important psychosocial work factors were work group climate, sense of mastery, job control, overall job strain, frustrated empathy, balancing competing needs, balancing emotional involvement and lack of recognition. Receiving more HCS hours was associated with stronger relationships between working conditions and satisfaction with care, especially with overall satisfaction and treatment by staff as outcomes. Managers and policymakers for home care need to acknowledge that the working conditions of home care staff are crucial for the satisfaction of older persons receiving HCS, particularly those receiving many HCS hours. Psychosocial work factors together with job strain factors are areas to focus on in order to improve working conditions for staff and outcomes for older persons.
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| 5. |
- Cameron, Lisa J. H., et al.
(författare)
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Earning Their Keep : The Productivity of Older Women and Men in Rural Bangladesh
- 2010
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Ingår i: Journal of Cross-Cultural Gerontology. - : Springer Netherlands. - 0169-3816 .- 1573-0719. ; 25:1, s. 87-103
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Tidskriftsartikel (refereegranskat)abstract
- In Bangladesh, being active and able to participate in productive activities is often essential to ensure ongoing health and survival. This study aims to describe and explore the patterns of participation in productive activities by older people in Matlab, a rural area of Bangladesh. Data from a cross sectional survey of people over 60 years of age was utilised. Six hundred and twenty five men and women participated in home based interviews providing information about their participation in productive activities including work, domestic activities and community groups. Overall, 94.4% of subjects reported participation in at least one productive activity. Men were the main participants in paid work and community groups, with 62% reporting engagement in paid work and 44% contributing to community groups. Both men (95.4%) and women (91.9%) reported performing at least one domestic activity. Performance of higher numbers of domestic tasks was associated with being younger, female, not requiring any assistance with self care, not married, not living with any children and earning between 100–999 Bangladesh Taka in the past month. Participation in community groups was low with only 26% of the sample reporting any involvement. This study indicates a high level of productivity in the older population in Matlab which benefits the individual, the family and the wider community. The safety and suitability of typical productive activities needs further investigation, in order to inform strategies protecting the older population from the effects of over work and harmful activities.
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| 6. |
- Fagerström, Cecilia, Docent, 1973-, et al.
(författare)
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Everyday Health among Older People : A Comparison between Two Countries with Variant Life Conditions
- 2017
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Ingår i: Journal of Aging Research. - : Hindawi Limited. - 2090-2204 .- 2090-2212. ; 2017
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Tidskriftsartikel (refereegranskat)abstract
- This study described health factors of importance for everyday health, such as pain, tiredness, and sleeping problems, in a cross-national context. Data for persons 60+ years were obtained from the Poverty and Health in Aging study, Bangladesh, and the Swedish National Study on Aging and Care-Blekinge. The strongest associations with everyday health in Sweden were found for pain and tiredness, while in Bangladesh they were financial status, tiredness, and sleeping problems. As similarities were found regarding the associations of tiredness on everyday health, tiredness may be a universal predictor of everyday health in older adults irrespective of country context.
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| 7. |
- Ferdous, Tamanna, 1974-
(författare)
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Determinants and Functional Impact of Nutritional Status Among Older Persons in Rural Bangladesh
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Malnutrition is a major problem in Bangladesh. One third of the population in Bangladesh is malnourished, but figures for older persons specifically are scant. Aims: This thesis describes the nutritional status of individuals aged 60+ years, living in a rural community in Bangladesh, with particular focus on the impact of demographic, health and social factors on nutritional status. A main aim is to examine the magnitude of malnutrition in this population. Second, the thesis focuses on the impact of demographic, health and social factors on nutritional status. Third, this thesis also aims to investigate the influence of nutritional status on functional abilities. Methods: A cross-sectional study of people aged 60+ years was conducted in Matlab, a rural area in Bangladesh during 2003-2004. Data were obtained through home interviews, clinical examination and cognitive tests. Nutritional status was assessed using a modified form of the Mini Nutritional Assessment. Physical function was measured by self-reported and performance-based instruments. Cognitive function was assessed using general and specific cognitive tasks. A total of 850 individuals were randomly selected for the purpose of the study, of which 625 participated in the home interviews and 473 underwent clinical examinations and cognitive tests. Information on complete nutritional status was available for 457 individuals. Results: About 26% of older people living in a rural community in Bangladesh were malnourished and 62% were at risk of malnutrition (Studies I-IV). Self-reported health problems (Study I), physician’s diagnoses (Study II), food expenditure (Study I), literacy (Studies I, II), personal income (Study II), female gender (Studies I, II) and financial support (Study II) were significantly associated with nutritional status. Health indicators accounted for the largest variations in nutritional status compared to demographic and socio-economic indicators (Studies I, II). Nutritional status was directly associated with self-reported and performance-based physical functions (Study III), as well as general and specific cognitive functions (Study IV). Conclusion: In low income countries, nutritional status of older persons needs to be addressed both from a health and a socio-economic perspective. Good nutritional status is essential for older persons to be functionally active, both physically and cognitively.
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| 8. |
- Ferdous, Tamanna, 1974-, et al.
(författare)
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Nutritional Status and Cognitive Function in Community-Living Rural Bangladeshi Older Adults : Data from the Poverty and Health in Ageing Project
- 2010
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Ingår i: Journal of The American Geriatrics Society. - : Wiley. - 0002-8614 .- 1532-5415. ; 58:5, s. 919-924
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES To investigate the association between nutritional status and general and specific (fluid and crystallized) cognitive functioning in a group of older people living in a rural area in Bangladesh. DESIGN Cross-sectional study. SETTING Matlab, Bangladesh. PARTICIPANTS Four hundred fifty-seven randomly selected persons aged 60 and older (mean age 69.5 +/- 6.8), 55% female. MEASUREMENTS Nutritional status was evaluated using a modified form of the Mini Nutritional Assessment (MNA). General cognitive function was assessed using the Bangla Adaptation of the Mini-Mental State Examination, and a word synonym test was used to test semantic memory function (a crystallized ability). To assess cognitive processing speed (a fluid ability), "cross balls" and "complete boxes" tests (scores/time unit) were used. Clinical diagnoses were registered. Structured questionnaires were used to assess demographic and socioeconomic status of the participants. RESULTS Twenty-six percent of the participants were undernourished, and 62% were at risk of malnutrition according to the MNA. The MNA scores were significantly lower in women than in men (P=.01). Women performed worse than men in all three cognitive tasks (P <.001). Poorer cognitive performance was independently associated with older age, female sex, illiteracy, visual impairment, severity of disease, and depressive symptoms. There were significant associations between better nutritional status and better cognitive performance tests of general ability and processing speed, whereas semantic memory appeared to be less affected. CONCLUSION The association between nutritional status and cognitive function involves general and specific cognitive abilities, with fluid ability seeming to be affected but crystalized functions being relatively spared.
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| 9. |
- Ferdous, Tamanna, 1974-, et al.
(författare)
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Nutritional status and self-reported and performance-based evaluation of physical function of elderly persons in rural Bangladesh
- 2009
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Ingår i: Scandinavian Journal of Public Health. - : Sage. - 1403-4948 .- 1651-1905. ; 37:5, s. 518-524
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the impact of nutritional status on self-reportedas well as performance-based indicators of physical functionin a rural elderly population in Bangladesh. Methods: A cross-sectionalstudy conducted in Matlab, Bangladesh, included 457 randomlyselected community-living elderly persons aged 60 years or more(60—92 years; 69 ± 7 years). Mobility, activitiesof daily living (ADL), performance tests, handgrip strength,the Mini Nutritional Assessment (MNA) and a structured questionnairewere used to assess physical function, nutritional status, socioeconomicstatus and health status, respectively. Descriptive and linearhierarchical regression analyses were applied. Results: Sevenper cent of the participants reported limitations in mobility,and 8% reported limitations in ADL. However, more than halfof the participants had difficulties in performing one or moreitems in the performance tests. According to the MNA, 26% ofthe participants were undernourished and 62% were at risk ofmalnutrition. More undernourished participants than well-nourishedparticipants reported limited mobility, impaired ADL and difficultiesin the performance tests. A corresponding reduction in gripstrength was observed in the undernourished group. Accordingly,higher MNA scores, indicating better nutritional status, weresignificantly associated with higher mobility index, higherADL index, higher performance tests index, and higher scoresin handgrip strength. These associations remained after adjustingfor demographic, socioeconomic and health status differences.Conclusions: Good nutritional status is important for the physicalfunction of elderly people, even after controlling for possibleconfounders. Performance tests indicated a higher degree offunctional impairment than that observed by self-reported estimation.
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| 10. |
- Ferdous, Tamanna, 1974-, et al.
(författare)
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The multidimensional background of malnutrition among rural older individuals in Bangladesh : A challenge for the Millennium Development Goal
- 2009
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Ingår i: Public Health Nutrition. - Cambridge : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 12:12, s. 2270-2278
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the associations and relative impact of illness, socio-economic and social indicators for nutritional status among elderly persons in rural Bangladesh.Design: A multidisciplinary, cross-sectional study employing home interviews to collect information on demographic, socio-economic and social status; clinical examination to classify medical diagnoses; and Mini Nutritional Assessment (MNA) to assess the nutritional status of each participant.Setting: Matlab, Bangladesh.Subjects: A total of 625 randomly selected individuals (≥60 years of age) participated in home interviews and 473 underwent clinical examination. Complete information on nutritional status was available for 457 individuals, median age 68 years, 55 % women.Results: Twenty-six per cent of the elderly participants were undernourished and 62 % were at risk of malnutrition according to MNA. More than three-quarters of the participants had acute infections, 66 % suffered from chronic illnesses, 36 % had sensory impairments and 81 % were suffering from gastrointestinal disorders. Acute infections (P < 0·001), gastrointestinal disorders (P < 0·01), depressive symptoms (P < 0·001) and impaired cognitive function (P < 0·01) were significantly and independently associated with poorer nutritional status. Moreover, female gender (P < 0·05), having no income (P < 0·01), being illiterate (P < 0·01) and not receiving regular financial support (P < 0·05) were also independently associated with poor nutritional status.Conclusions: Malnutrition among elderly people in rural Bangladesh is associated with female gender, medical, psychological, socio-economic and social indicators. A multidimensional approach is probably needed to reduce undernutrition in older populations in low-income countries like Bangladesh.
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