OBJECTIVE: This review aimed to assess the influence of tai chi on postural stability and quality of life in older adults with abnormal gait.
METHOD: According to the literature retrieval principles, the works published from the inception date to May 2023 were retrieved, including the following databases: PubMed, Scopus, Web of Science, China National Knowledge Infrastructure, EBSCOhost, and Google Scholar. Subsequently, literature screening and quality assessment were performed.
RESULTS: A total of 16 randomized controlled trials were included in this study, Tai Chi intervention can affect populations with Parkinson's disease (PD), no exercise, mild cognitive impairment (MCI), chronic stroke, sedentary, fear of falling, or history of falling. Postural instability is associated with balance, gait, the Unified Parkinson's Disease Rating Scale Motor Subscale 3 (UPDRS III), mobility, lower body strength, and falls. Only two articles looked at quality of life. The Yang style is the most commonly used in the intervention. Nonetheless, most studies were performed on female participants, hence, more research on older male populations is needed.
CONCLUSION: Tai Chi intervention benefits postural balance in patients with gait disorders. 12 weeks is the most common intervention period for patients with gait disorders. The frequency of intervention is seven articles twice a week, and the intervention time is about 60 minutes. The Tai Chi intervention methods in this study involve Yang Style, Sun Style, Taoist Tai Chi, and Health Qigong Tai Chi, but the Yang Style Tai Chi intervention is the most widely used.
Methods: In-depth interviews were conducted with 17 women, ages 21-56 who were either divorced or currently in the process of getting divorced in Kelantan, Malaysia.
Results: Several themes emerged, indicating the following five reasons for divorce: 1) reaching the point of ultimatum, 2) having adequate support pre- and post-divorce, 3) concern for children's welfare, 4) seeking financial independence, and 5) fear of harm.
Conclusion: The identification of the driving factors for divorce may spark a change in our society's mindset to empower female divorcees and allow them to lead happy, abuse-free lives.
METHODS: This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged ≥60 years. A semi-structured questionnaire was used to collect information on participants' characteristics and COVID-19 related information. Perceived fear of COVID-19 was measured using the seven-item Fear of COVID-19 Scale (FCV-19S), where the cumulative score ranged from 7 to 35. Multiple linear regression was performed to identify factors associated with perceived fear of COVID-19.
RESULTS: The mean fear score was 19.4. Participants who were concerned about COVID-19 (β: 2.75, 95% CI: 1.71 to 3.78) and overwhelmed by COVID-19 (β: 3.31, 95% CI: 2.33 to 4.29) were significantly more likely to be fearful of COVID-19. Moreover, older adults who felt themselves isolated from others and whose close friends and family members were diagnosed with COVID-19 were more fearful. However, the participants who received COVID-19 related information from the health workers had a lower level of fear (β: -1.90, 95% CI: - 3.06 to - 0.73).
CONCLUSIONS: The presence of overwhelming fear of COVID-19 among the older adults of Bangladesh underlines the psychological needs of these vulnerable groups. Health workers have a key role in addressing these needs and further research is needed to identify the effective strategies for them to use.
Objectives: This qualitative study examines factors affecting the adherence to HIV/AIDS treatment among patients with HIV/AIDS at a local hospital in Malaysia.
Methods: The data from purposefully selected patients were collected by in-depth interviews using a pretested interview guide. Saturation was reached at the 13th interview. All interviews were audio-taped and transcribed verbatim for analysis using thematic content analysis.
Results: Fear and stigma of perceived negative image of HIV diagnosis, lack of disease understating, poor support from the community, and perceived severity or the treatment side effects were among the reasons of nonadherence. Appropriate education and motivation from the doctors and reduction in pill burden were suggested to improve adherence.
Conclusion: Educational interventions, self-management, and peer and community supports were among the factors suggested to improve adherence. This necessitates uncovering efficient ways to boost doctor-patient communication and recognizing the role of support group for the social and psychological well-being of the patients.
OBJECTIVE: To compare the fall history between older adults with and without a previous stroke and to identify the determinants of falls and fear of falling in older stroke survivors.
DESIGN: Case-control observational study.
SETTING: Primary teaching hospital.
PARTICIPANTS: Seventy-five patients with stroke (mean age ± standard deviation, 66 ± 7 years) and 50 age-matched control participants with no previous stroke were tested.
METHODS: Fall history, fear of falling, and physical, cognitive, and psychological function were assessed. A χ2 test was performed to compare characteristics between groups, and logistic regression was performed to determine the risk factors for falls and fear of falling.
MAIN OUTCOME MEASURES: Fall events in the past 12 months, Fall Efficacy Scale-International, Berg Balance Scale, Functional Ambulation Category, Fatigue Severity Scale, Montreal Cognitive Assessment, and Patient Healthy Questionnaire-9 were measured for all participants. Fugl-Meyer Motor Assessment was used to quantify severity of stroke motor impairments.
RESULTS: Twenty-three patients and 13 control participants reported at least one fall in the past 12 months (P = .58). Nine participants with stroke had recurrent falls (≥2 falls) compared with none of the control participants (P < .01). Participants with stroke reported greater concern for falling than did nonstroke control participants (P < .01). Female gender was associated with falls in the nonstroke group, whereas falls in the stroke group were not significantly associated with any measured outcomes. Fear of falling in the stroke group was associated with functional ambulation level and balance. Functional ambulation level alone explained 22% of variance in fear of falling in the stroke group.
CONCLUSIONS: Compared with persons without a stroke, patients with stroke were significantly more likely to experience recurrent falls and fear of falling. Falls in patients with stroke were not explained by any of the outcome measures used, whereas fear of falling was predicted by functional ambulation level. This study has identified potentially modifiable risk factors with which to devise future prevention strategies for falls in patients with stroke.
LEVEL OF EVIDENCE: III.
STUDY DESIGN: This was a systematic review.
METHODS: Published research studies on FOF among older adults were searched using the following databases: PubMed, Cochrane Library, Scopus, ASEAN Citation Index, Thai Journal Citation Index, Malaysian Journal Citation Report and Google Scholar. All observational and experimental studies investigating FOF among community-dwelling older adults in Southeast Asia were eligible. A narrative synthesis was used to describe the findings. The Joanna Briggs Institute checklist was used to assess the quality and risk of bias of the included studies.
RESULTS: A total of 15 observational studies and three experimental studies were included after screening 2112 titles and abstracts. These studies, published between 2011 and 2021, were conducted in Malaysia, Singapore, Thailand and Vietnam. The FOF prevalence ranged from 21.6% to 88.2%. The most commonly used FOF assessment tool was the Falls Efficacy Scale-International. Well-reported related factors of FOF were female sex, advanced age, balance impairment and fall history. All experimental studies utilising single- or multi-component interventions comprised an exercise approach. Limited studies have considered environmental factors.
CONCLUSIONS: Various related factors of FOF and the interventions implemented were revealed. Public health researchers and policymakers should consider the factors related to FOF in practical FOF intervention and prevention strategies. Further evidence on FOF issues is required to understand the multidimensional characteristics of FOF, specifically the environmental aspects of older adults in Southeast Asia.
METHODS: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs.
RESULTS: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support.
CONCLUSIONS: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD.