Abstract
Musculoskeletal disorders and comorbid depression: Associations with working conditions among aging nurses
Yuan Zhang, PhD, RN1 and Kefang Wang, PhD2
(1)University of Massachusetts Lowell, Lowell, MA, (2)Shandong University, Jinan, Shandong Province, China
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Introduction: Musculoskeletal disorders (MSDs) are the leading cause of pain and disability among healthcare workers, and are frequently accompanied by comorbid symptoms, such as depression. However, the association between various working conditions and a comorbidity of MSDs and depression has not been studied.
Methods: Questionnaires were collected with registered nurses and licensed practical nurses at a community hospital in Massachusetts. Working conditions assessed include physical demands, psychological demands, decision authority, social support, and work-family conflict. MSDs were assessed for six regions: low back, shoulder, neck, wrist/forearm, knee, and ankle/feet; and were defined as “yes” for participants reporting moderate, severe, or extreme pain in any region. Depression was measured with the Center for Epidemiology Studies Depression Scale.
Results: Among 397 nurses (95% female; age 43±12 y), 47.4% reported MSDs, and 24.4% reported depression. Almost 15% reported a comorbidity of MSDs and depression. Multivariate robust Poisson regressions reported that work-family conflict was associated with increased risk of the comorbidity (PR=2.18, p<0.01), after adjustment for age, gender, race, BMI, regular exercise, shift work, and other working conditions. Other working conditions were not directly associated with the comorbidity; however, psychological demands and decision authority were significantly associated with work-family conflict.
Conclusion: Work-family conflict was associated with a comorbidity of MSDs and depression among aging nurses. Longitudinal studies are needed to explore the causal relationships among these factors. Effective workplace programs are needed to address work-family conflict as well as other working conditions in order to promote physical and mental well-being of aging nurses.
Occupational health and safety Public health or related nursing Public health or related research
Abstract
Cost of Behavioral Crises Related to Alzheimer's Disease and Related Dementias on First Responder Systems: An exploratory study
Trina Stolp, BS1 and Sarah E. Toevs, PhD2
(1)Center for the Study of Aging, Boise, ID, (2)Boise State University, Boise, ID
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Enhancing quality of life for people with dementia is identified in Healthy People 2020 as a public health priority. In Idaho, the proportion of individuals diagnosed with Alzheimer's disease and related dementias (ADRD) is projected to increase by 81 % - 127 % between 2000 and 2025. Policies designed to address needs of this population must be based on an understanding of system wide impacts of disease. This study examined costs of behavioral crises associated with ADRD on first responder systems. It was delimited to the most populated region of Idaho and “first responders” were defined as individuals employed in mobile crises, EMS, and health care settings.
Information was collected from incident reports from EMS and key informant first responders. All research procedures were approved by the Boise State University Institutional Review Board.
EMS receives approximately 22,000 calls annually with 924 of calls related to behavioral crisis involving individuals with ADRD. Most calls were from assisted living facilities (n=401), home (n=290), or skilled nursing facilities (n=181). The majority (80%) of calls resulted in transport to a hospital emergency department (ED); none of the calls required use of lights or siren. Annual costs of calls to EMS and ED were estimated to be $457,380 and $905,020, respectively. Themes from key informants included: an increase in number and complexity of calls; lack of appropriate protocols within systems to support individual in crisis or their family or caregiver; and need for training on progression of ADRD and de-escalation strategies.
Assessment of individual and community needs for health education Chronic disease management and prevention Conduct evaluation related to programs, research, and other areas of practice Public health or related organizational policy, standards, or other guidelines Public health or related public policy
Abstract
Social participation and onset of dementia in elderly men and women: A 10-year follow-up study
Tami Saito-Kokusho, PhD1, Chiyoe Murata, PhD, MPH1, Katsunori Kondo, MD, PhD2, Kokoro Shirai, PhD3, Masashige Saito, PhD4, Tokunori Takeda, OTR, PhD5, Toshiyuki Ojima, MD, PhD6 and Takao Suzuki, MD, PhD7
(1)National Center for Geriatrics and Gerontology, Obu, Japan, (2)Chiba University, Chiba, Japan, (3)University of the Ryukyus, Nishihara, Japan, (4)Nihon Fukushi University, Mihamacho, Japan, (5)Seijoh University, Tokai, Japan, (6)Hamamatsu University School of Medicine, Hamamatsu, Japan, (7)JF Oberlin University, Machida, Japan
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
Prevention of dementia is an important public health issue. Studies have shown that social participation could decrease the risk of dementia. To provide more insight, this study examined the effect of frequency of participation and contents of group activities on dementia onset during the 10-year follow-up period.
We obtained data from the Japan Gerontological Study (JAGES) Project. We analyzed 13792 people aged ≥65 years without any limitations in the activities of daily living. Data regarding dementia onset during the 10-year period were obtained from the Long-term Care Insurance System. We assessed eight types of groups (e.g., sports group, hobby group, or volunteering group) to which the participants belonged and the frequency of participation in any group activities was classified into five categories (from none to several times or more per week).
During the follow-up period, 13.6% and 17.3% of men and women, respectively, developed dementia. A multivariate Cox proportional hazards model showed that neither the participation frequency nor any contents of group activities had a significant effect on dementia onset in men. Conversely, in women, weekly or more frequent participation significantly decreased the risk of dementia onset compared to no participation. Additionally, women participating in a sports or hobby group had a significantly lower risk of dementia onset.
The study findings suggest that promoting weekly social participation or participation in a sports or hobby group could be effective for preventing dementia in women. On the other hand, it is important to develop a customized program for elderly men.
Assessment of individual and community needs for health education Diversity and culture Epidemiology Planning of health education strategies, interventions, and programs Provision of health care to the public Social and behavioral sciences
Abstract
Evaluating Dementia-Capable Community Development: Collective Action in Minnesota
Deborah Paone, DrPH, MHSA
Paone & Associates, LLC, Minneapolis, MN
APHA 2016 Annual Meeting & Expo (Oct. 29 - Nov. 2, 2016)
A 2-year formative evaluation of the ACT on Alzheimer's initiative examined a set of Minnesota communities working through a structured community participatory process to build “dementia capability.” Through mixed methods, the evaluation identified implementation factors, successes, and challenges, as communities worked through this engagement process. The statewide initiative as a large-scale collective action effort was very successful, with hundreds of health care/social service professionals, caregivers, local/state government agency representatives, and community members involved. In-depth study of several communities in St. Paul, Minneapolis, and rural Minnesota, offered insight into coalition development methods as well as community-defined measures of impact. Key informant interviews, surveys, and focus groups with leaders in the initiative and with highly engaged caregivers of persons with Alzheimer's disease provided nearly real-time insights that were used to inform and guide the work as well as document learning. The second year of the evaluation included preliminary efforts to define elements for measuring a dementia capable community. Findings included the following: that proactively selecting and engaging highly credible experts in the field, from across sectors in the community, together with the shared ownership, strong goals, and structured support were highly effective strategies. The strategies built credibility and attracted and capitalized on both in-kind and foundation funding. At the community level, a key success factor was a strong local program champion with superior skills in facilitation and communication. Evaluation of a fast-evolving set of communities working under a large coalition effort presented special challenges.
Administer health education strategies, interventions and programs Conduct evaluation related to programs, research, and other areas of practice Implementation of health education strategies, interventions and programs Planning of health education strategies, interventions, and programs Public health or related research Systems thinking models (conceptual and theoretical models), applications related to public health