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Biomedical subjects

T R Prohaska

Publications and source records attributed to T R Prohaska.

At least 19 recordsLinked to original sources
PubMed1999

Nursing home admission for African Americans with Alzheimer's disease.

BACKGROUND: For African Americans with Alzheimer's disease (AD), little is known about the time to, and risk factors for, nursing home admission (NHA). Using Consortium To Establish a Registry for Alzheimer's Disease (CERAD) data, this study provides information on NHA for African Americans. METHODS: This longitudinal study followed subjects (N=122) for as long as 7 years and used survival analysis methodology and variable values at baseline and at follow-up to identify NHA risk factors. Studied were sociodemographic variables, physical symptom and disease status variables, the Blessed Dementia Rating Scale (including subscores), the Clinical Dementia Rating (CDR), and the Mini-Mental State Examination. RESULTS: Only 25% of African Americans with AD were estimated to have had a NHA by 3.4 years (confidence interval 2.1, 5.4). Being unmarried resulted in a five times earlier NHA (p< .01), and each unit increase in the CDR resulted in a 74% earlier NHA (p<.01). In the absence of the CDR, limitation in activities of daily living was associated with earlier NHA (p<.05). CONCLUSIONS: Findings suggest that African Americans with AD spend a substantial time in the community prior to NHA, a longer time than observed in similar studies among whites. This raises public health and clinical concern that African Americans with AD may be residing in the community with substantial unmet needs, and that their caregivers have potentially high levels of burden. The independent associations with time to NHA observed here, although few in number, are consistent with other related research.

Aged↗
PubMed1998

Time to nursing home admission for persons with Alzheimer's disease: the effect of health care system characteristics.

OBJECTIVE: To study the influence of state health care system characteristics on time to nursing home admission (NHA) for persons with Alzheimer's disease (AD). METHOD: Up to nine years of Consortium to Establish a Registry for Alzheimer's Disease (CERAD) data on 639 non-Latino White individuals were merged with longitudinal data from the 28 states in which the CERAD participants resided. The state variables reflected characteristics of each state's long-term care (LTC) system, including Medicaid LTC spending practices and the supply of LTC providers. Cox Proportional Hazards Models with time-varying covariates were used to evaluate the risk factors associated with time to NHA. RESULTS: There was differential influence of state variables by marital status. For unmarried non-Latino White persons with AD, a higher percentage of Medicaid LTC spending on home and community-based services (HCBS) was significantly associated with a longer time to NHA. For married persons, a greater number of home health agencies was associated with a longer time to NHA. Other associations also varied by marital status. CONCLUSION: Study findings support the utility of targeted continued expanded provision of HCBS by states and provide a basis for future research regarding the impact of changing state health care systems on LTC utilization for persons with AD.

Aged↗
PubMed1998

Older adults and assistive devices: use, multiple-device use, and need.

Responses of older adults ( greater than 65 years) from the 1990 National Health Interview Survey and Assistive Device Supplement are analyzed to determine if selected demographic and health variables are associated with the use of assistive devices, multiple-device use, and the expressed need for such devices. Bivariate and multi-variate analyses show that, in general, poorer health is consistently associated with the use of assistive devices, multiple-device use, and expressed need. Demographic characteristics, however, vary in their relationships to assistive device use and need. Findings support the importance of considering multiple-device use and expressed need in studying assistive devices and older adults.

Aged↗
PubMed1996

A survey of exercise beliefs and exercise habits among people with arthritis.

OBJECTIVE: To explore a possible explanation for the problem of why few people exercise despite the positive health advantages, by examining the relationship between exercise beliefs and participation in exercise activities. METHODS: Eighty-one respondents aged 27-80 were recruited from 3 Chicago-area health care facilities to complete the study survey; 68 (84%) did so. Participants were asked about their participation in 6 types of exercise activities; they also reported their beliefs concerning their ability to exercise (self-efficacy for exercise), barriers to exercise, benefits of exercise, and the impact of exercise on their arthritis. RESULTS: Study results indicate that belief in the benefits of exercise and self-efficacy for exercise are associated with participation in exercise activities. Also, severity of disease differentiated exercisers from non-exercisers. CONCLUSIONS: Results suggest the importance of finding ways to strengthen belief in the benefits of exercise and self-efficacy for exercise in people with arthritis, particularly people with moderate to severe disease-related limitations.

Adult↗
PubMed1995

Attitudes and practices for smoking cessation counseling by provider type and patient age.

Attitudes and self-reported practices for smoking cessation counseling among 145 providers at a health maintenance organization were compared among two provider groups, physicians/nurse practitioners and registered/licensed practical nurses, and across three patient age groups, < 50, 50-64, and > or = 65. Smoking cessation attitudes did not differ by provider type but they did differ by patient age, especially among the registered/licensed practical nurses, whose attitudes were least favorable for the oldest smokers (> or = 65). While smoking cessation practices did not differ by patient age, they did differ by provider type. Self-reported performance of the 4 As of smoking cessation practice (Ask, Advise, Assist, Arrange) was more frequent among the physicians/nurse practitioners than among the registered/licensed practical nurses. However, among both groups, asking and advising practices were reported more often than were assisting and arranging. In all cases, different attitudes were correlated with different practice behaviors for the two provider groups. Also, there were more significant correlations between age-specific attitudes and practices among the registered/licensed practical nurses than among the physicians/nurse practitioners. This was true especially regarding the oldest patients. The findings suggest a need for provider education, especially among registered/licensed practical nurses, about the benefits of smoking cessation for patients of all ages and the potential effectiveness of provider-based intervention strategies that are targeted toward specific age groups. The findings also suggest that assisting and arranging practices in particular need improvement among all types of providers.

Adult↗
PubMed1995

Readiness of older adults to stop smoking in a televised intervention.

Smokers aged 60 and older who enrolled in a televised smoking cessation program were compared with older smokers in the target population, using data from telephone interviews. Multiple logistic regressions identified factors that differentiated older smokers at various stages of readiness to quit. Within the target population, smokers planning to quit someday (N = 238) were more likely to have had greater concern about health effects of smoking and perceived a stronger desire by others for them to quit than smokers with no such plan (N = 127). Compared with older smokers in the target population who were planning to quit someday, program registrants (N = 95) perceived greater severity of lung cancer, had greater concern about the health effects of smoking, perceived greater reduction of lung cancer risk from quitting, and had more determination to quit. These findings indicate important factors according to the stage in the smoking cessation process that must be considered when intervening with older smokers.

Aged↗
PubMed1991

Cervical cancer screening in older women. Issues and interventions.

Although some controversy exists, the Papanicolaou (Pap) smear for cervical cancer screening is widely accepted as an effective mechanism for cancer control. An issue of interest to clinicians and behavioral scientists is the underrepresentation of elderly women in populations screened. It is important for nurses to understand the issues, and hypothesized reasons behind this phenomenon, in order to develop interventions to counteract it. The authors examine this problem from a number of behavioral and clinical perspectives and discuss nursing interventions to improve cervical cancer screening in older women.

Aged↗
PubMed1990

Determinants of self-perceived risk for AIDS.

This paper examines self-perceptions of risk for AIDS and factors that contribute to estimations of risk. On the basis of a telephone survey of 1,540 adults age 18 to 60, we address the question: What heuristic factors predict perception of risk for AIDS? Results show that five heuristic categories determine self-perceptions of risk: sexual practices, moral evaluations of people with AIDS, emotional response to AIDS, protective actions in response to AIDS, and demographic characteristics. Number of sexual partners over the past five years and knowledge of sexual partners' past sexual behavior are associated significantly with increased perceptions of risk. Fear of AIDS and worry about one's health also contribute significantly to self-perception of risk, as does shame associated with having AIDS. Asian-Americans and persons with no particular religious affiliation report greater perceptions of risk. These findings call attention to heuristic factors in considering theories of risk and in designing interventions to change preventive actions associated with high risk for AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Beliefs about aging and illness in a community sample.

Findings from recent studies have demonstrated age group differences in coping with illness. One explanation for these age group differences has received little attention: perceptions of illness may differ with age and these differences in perception may account for the observed differences in coping. The purpose of this study was to examine the effects of age on illness perceptions along dimensions that influence coping. Specifically, we explored perceptions about aging as a cause of illness and perceptions about the effect of age on seriousness, curability and controllability of illness. Four hundred fifty-one community-dwelling adults (age range 20 to 90 years) participated in the study. The pattern of results showed respondents of all ages expressing the belief that aging is associated with increased susceptibility to disease and lowered potential for control or cure. Implications of these beliefs for health monitoring and coping with illness are discussed.

Adaptation, Psychological↗
PubMed1989

Who hasn't heard about AIDS?

This article analyzes who among the general population has not heard about AIDS despite intensive educational programs and widespread media attention about the syndrome. The data are drawn from a survey of the general public's knowledge, attitudes, and behavior toward AIDS in May-July, 1987 to establish a baseline for future educational interventions and to identify groups in need of special educational efforts. A total of 1540 interviews were conducted in Chicago and the surrounding six-county metropolitan area with adults between the ages of 18 and 60 in a two-stage cluster sample designed to compare blacks, whites, and Hispanics. Of the 1540 respondents, 49 (3.2%) had never heard of AIDS. Contingency table and logistic regression analyses indicated that lower educational levels and being Hispanic or Asian predict not having heard about AIDS. The results suggest the need for programs and intervention strategies that consider the special characteristics of these populations.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Impact of symptoms and aging attribution on emotions and coping.

Two experimental studies and a large field study were designed to examine how symptom severity, symptom duration, symptom ambiguity, and the association of symptoms with aging affected emotional responses and coping with illness threats. In Study 1, 280 respondents from the surrounding community reported the emotional and coping responses they would manifest to scenarios that varied the severity, duration, and ambiguity (i.e., labeled vs. unlabeled) of a common set of symptoms. Severity had more of an impact on coping strategies than did duration or illness label; severe symptoms elicited stronger emotional upset and a higher incidence of both self-care behaviors and seeking of medical care. Symptoms of longer duration also resulted in increased seeking of medical care. Responses of the 334 adults participating in Study 2 replicated and extended these findings: A closed-ended item asking participants whether the symptoms could be attributed to aging showed that attribution of symptoms to aging increased with age, was more frequent for mild symptoms, and was associated with reduced emotional response to symptoms and a tendency to delay seeking treatment. Participants in the field study (168 patients seeking medical care for a variety of symptoms) completed interviews tracing symptom processing and emotional and coping reactions. The results provided evidence for the external validity of the scenario studies, as the attribution of symptoms to aging was greater for older than younger patients and resulted in a significant tendency to delay seeking medical care. Results of these studies suggest that symptom experience and symptom interpretation must be considered in the study of coping responses to illness threats.

Adaptation, Psychological↗
PubMed1986

Age, symptom interpretation, and health behavior.

The role of symptom perceptions and utilization of health promoting practices in illness behavior were explored across the adult lifespan. The first study (N = 396) assessed the health practices and perceptions about illnesses in well adults (ages 20 to 89) as well as perceptions about symptoms associated with a group of six specific illnesses. The second community study (N = 614) examined how symptom qualities (symptom severity, duration, and illness label) affect attributions of symptoms to aging and coping strategies in response to the symptoms. The findings revealed that while the elderly report more frequent performance of health promoting activities, perceptions about illnesses and how to prevent them are comparable across adulthood. Symptoms used to identify illnesses are also equivalent across adulthood (and aging) except for the reduced usage of mild ambiguous symptoms in identifying illnesses by the elderly. The frequency with which mild, short-term symptoms are attributed to aging increases with age of the subjects and leads to greater acceptance of the illness symptoms and more passive coping strategies. Clinical implications and policy recommendations are discussed.

Adaptation, Psychological↗
PubMed1985

Health practices and illness cognition in young, middle aged, and elderly adults.

The present paper examines reported frequencies of 21 health practices, beliefs that these health practices can prevent six different illnesses, and beliefs about those illnesses in a community sample of 396 people: 173 young (20 to 39 years), 111 middle-aged (40 to 59 years), and 112 elderly adults (60 to 89 years). Elderly respondents report higher frequencies of health-promoting actions (e.g., regular medical check-ups, avoidance of salt, regular sleep, and eating a balanced diet) than younger respondents. Health practices aimed at reinterpreting stress and controlling emotions (e.g., avoiding emotional stress, staying mentally alert and active) also increased with age. Belief that these 21 practices prevent specific illnesses was consistent across the three age groups. Beliefs about the six illnesses were consistent across age with three exceptions: Elderly people considered themselves more vulnerable to disease, saw it as more serious for them, and were less likely to use chronic mild symptoms, like weakness and aches, as illness warnings.

Adult↗
PubMed1984

Age differences in attributions to causality: implications for intellectual assessment.

Negative attributions and failure expectations held by elderly test-takers may be confounding ability-extraneous variables and thus may contribute to lowered intellectual performance. The present study, using the contextualistic model, examined these confounds through experimental manipulation of causal attributions to test outcome in younger and older individuals. Eighty females (40 elderly; 40 younger) were exposed to noncontingent failure (unsolvable test items) and received a verbal massage stating their failure and relating it to either their ability, effort, or no cause. A fourth group exposed to identical failure was not given feedback. Subjects in all four groups for both ages were then administered three solvable intelligence sub-tests: Reasoning, Hidden Patterns, and Paper Folding. Older subjects exhibited significantly lower success expectations and performed more poorly on all three tests. Also, older and younger subjects, in the absence of suggested causal ascription, showed differential performance in the Paper Folding Test. Younger subjects with no experimenter-given cause for failure exhibited facilitation of performance while older subjects' performances, under the same conditions, showed deficits. Results are discussed in reference to attributional style research and the contextualistic viewpoint.

Adolescent↗
PubMed1983

Efficiency of automatic depth in processing in the elderly.

Initial encoding of information in the elderly was examined within the framework of controlled vs automatic processing. Controlled processing demands conscious effort, whereas automatic processing is cost-free in this regard. The suggestion is that adequate encoding and storage could be hindered if semantic depth is not accessed automatically. A task developed by Warren to investigate automatic processing in young Ss was used to test whether words reached semantic levels automatically in elderly Ss. Twenty-four females, 12 young and 12 old, heard word triads. Each triad was followed by visual presentation of a single word in colored ink. For both young and old Ss, color-naming latency for the visual words was significantly higher if the word itself was present in the auditory triad. This indicated that the visual words were processed to the level of meaning automatically in both young and old Ss.

Adult↗
PubMed1981

Professional recommendations for long-term care placement: a comparison of two groups of institutionally vulnerable elderly.

This paper investigates client and service characteristics that differentiate placement recommendations in two groups of elderly who are vulnerable to institutionalization--community residents who have applied for nursing homes and acute care patients who were viewed as likely candidates for long term care facilities. The two groups differ considerably on measures of physical and mental well-being as well as service need and availability. The community applicants were in poorer overall condition except with respect to medical requirements. A separate discriminant analysis of placement recommendations (long term care institution versus community) was carried out for each group using the client and service need characteristics as the discriminating factors. The results suggested that some factors such as family care and ADL skills and requirements are important predictors of placement recommendations in both groups, but there were also a number of unique elements in each function. The authors stress the importance of population differences in institutional decisions.

Activities of Daily Living↗
PubMedDate not supplied

Age and the role of symptomatology in readiness to quit smoking.

To develop effective age-appropriate strategies for smoking cessation, it is important to understand factors associated with readiness to quit smoking. This article presents results from an analysis of the role of symptomatology in the decisions to quit smoking among three age groups (18-34, 35-54, and > or = 55 years) from a larger sample of smokers in a managed-care setting. Two measures of readiness to quit smoking were used: stages of change and intention to stop. Using ordinal logistic regression, we found that smokers in the middle and oldest age groups who had experienced at least three of five symptoms in the previous 2 weeks were more likely to be in higher stages of readiness. Regardless of age, smokers who attributed symptoms to smoking were more motivated to try to quit, whereas those who attributed symptoms to aging were less likely to intend to stop smoking. Findings from this study indicate a symptom-based approach to smoking cessation may be a useful strategy, especially in provider-based interventions.

Adult↗