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    The Association between the Self-Management of Mild Symptoms and Quality of Life of Elderly Populations in Rural Communities: A Cross-Sectional Study. Ohta Ryuichi,Sato Mikiya,Kitayuguchi Jun,Maeno Tetsuhiro,Sano Chiaki International journal of environmental research and public health Maintaining people's health based on their help-seeking behavior (HSB) regarding mild symptoms is essential. An effective HSB, especially self-management, can facilitate the attainment of appropriate healthcare resources and affect health outcomes such as quality of life (QOL). However, clear evidence regarding the relationship between self-management, mild symptoms, and QOL is unavailable. Therefore, this cross-sectional study investigated this association in a rural elderly population. The participants, aged over 65 years, were living in rural communities. The primary outcome of QOL was examined using the EuroQol 5-Dimension 5-Level (EQ-5D-5L). After adjusting for propensity score matching, 298 participants in the self-management usage group were matched with 298 in the group not using self-management. The most frequent HSB trend was consulting with primary care physicians, followed by self-care, consulting with families, utilizing home medicines, and buying medicines. The EQ-5D-5L scores were statistically higher in the self-management usage group than in the other group. The HSBs with a trend of using self-management were related to a high QOL. Self-management of symptoms along with other HSBs can improve elderly HSBs in rural contexts. Educational interventions and system development for HSBs in rural contexts could be effective in enhancing the QOL of rural elderly populations. 10.3390/ijerph18168857
    Relationship Between Dietary Patterns and Chronic Diseases in Rural Population: Management Plays an Important Role in the Link. Frontiers in nutrition Objective:Health dietary pattern is related with reduced risk of chronic metabolic disease, but the benefits were not fully clear in the Chinese population. The aim of this study was to explore the association between dietary patterns and multiple chronic metabolic diseases in middle-aged and elderly Chinese. Methods:A total of 718 Chinese adults aged ≥ 45 who lived in the Huairou regions of Beijing were included in the present cross-sectional analysis from 2019 to 2020. Dietary data were obtained by food frequency questionnaires (FFQs). Dietary patterns were identified by principal components analysis (PCA). Logistic regression analysis and hierarchical analysis were used to examine the relationship among dietary patterns, health management, and chronic diseases. Results:Five dietary patterns were discovered in the subjects. The pattern with the higher percentage of energy supply by lipid was a risk factor for hypertension [odds ratio (OR) = 2.067, = 0.013]. Lower energy intake (OR = 0.512, = 0.012) and a reasonable ratio of dietary energy supply (OR = 0.506, = 0.011) were beneficial to diabetes. The substitution of potato for grain might be an effective way of reducing diabetes (OR = 0.372, < 0.001). The higher intake of high-quality protein was the protective factor for coronary heart disease (CHD; OR = 0.438, = 0.008). Moderate intervention (OR = 0.185, = 0.033) and appropriate health education (OR = 0.432, = 0.016) could greatly subserve the prevention of chronic diseases, especially for hyperlipidemia. Men were more likely to be affected by health education, intervention, and follow-up than women. The prevalence of multimorbidity was higher in women (43.2%) than men (41.5%). The staple food intake and health management were also important factors to prevent multimorbidity. Conclusion:Dietary pattern with appropriate energy intake, a reasonable source of energy supply, high quality of macronutrients, and moderate management was associated with decreased risk of chronic metabolic diseases. Further studies are needed to clarify the cause-effect relationship between dietary patterns, health management, and chronic diseases and give suggestions to chronic metabolic disease prevention in middle-aged and elderly people in a rural area. 10.3389/fnut.2022.866400
    A WeChat-Based Self-Management Intervention for Community Middle-Aged and Elderly Adults with Hypertension in Guangzhou, China: A Cluster-Randomized Controlled Trial. Li Xiaowen,Li Tong,Chen Jianying,Xie Yuanling,An Xia,Lv Yunhong,Lin Aihua International journal of environmental research and public health This study aimed to assess whether a WeChat-based self-management intervention would be effective for community middle-aged and elderly adults with hypertension in Guangzhou, China. We conducted a cluster-randomized control trial with a total of 464 participants (intervention, = 186; control, = 276) between March 2018 and May 2019. The self-management intervention lasted for 6 months, consisting of health education, health promotion, group chat, and blood pressure (BP) monitoring. All individuals in the baseline and follow-up surveys were assessed for BP and completed a hypertension knowledge questionnaire, self-efficacy scale, self-management scale, and social support scale. A total of 253 participants (intervention, = 110; control, = 143) completed the follow-up survey and were included in the analysis. The adjusted mean differences in the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between the intervention and control groups were -6.9 (95% Confidence Interval (CI) -11.2 to -2.6; = 0.002) and -3.1 (95% CI -5.7 to -0.6; = 0.016) mmHg, respectively. Individuals who participated in the intervention program had better BP monitoring, improved their hypertension self-management as well as parts of their disease knowledge and self-efficacy. The WeChat-based self-management intervention may be a feasible and efficient program to help Chinese community middle-aged and elderly hypertensive patients lower BP and improve self-management. 10.3390/ijerph16214058
    Improvement of social support in empty-nest elderly: results from an intervention study based on the Self-Mutual-Group model. Zhang Chichen,Zhao Huining,Zhu Ruifang,Lu Jiao,Hou Lihong,Yang Xiaozhao Yousef,Yin Mei,Yang Tingzhong Journal of public health (Oxford, England) BACKGROUND:China has the world's largest elderly population and an increasing number of empty-nest elderly. The purpose of this study is to evaluate the effectiveness of the Self-Mutual-Group model on social support of the empty-nest elderly, thus providing reference for improving their quality of life. METHODS:A intervention study was conducted between October 2016 and May 2017 at six communities in Taiyuan, Shanxi Province, China. A total of 350 empty-nest elderly aged 60-88 years were randomly assigned in the intervention group (n = 167) with a 7-month SMG-based intervention or to a control group (n = 183) with no intervention. The social support of the participating elderly (n = 350) was assessed by the Social Support Rating Scale (SSRS) at the baseline and 7 months later, respectively. RESULTS:A 7-month follow-up showed an increasing mean scores of SSRS, objective support, subjective support and support utilization of the intervention group, and reached statistical significance (P < 0.05). CONCLUSIONS:The Self-Mutual-Group model was considered to be a positive intervention and was effective in increasing social support among the empty-nest elderly. Furthermore, future research should extend the intervention period and introduce multi-point measurement to better evaluate the intervention process and outcomes. TRIAL REGISTRATION:Study on the 'SMG' Health Management Model Based on Community Organization Theory among empty-nest elderly (ChiCTR1800015884). 10.1093/pubmed/fdy185
    Effectiveness of self-management on adherence to self-care and on health status among elderly people with hypertension. Putri Silvia Elki,Rekawati Etty,Wati Dwi Nurviyandari Kusuma Journal of public health research BACKGROUND:Adherence to self-care is the goal of nursing care for elderly people with hypertension to give them optimal functional health status. The purpose of this paper is to determine the effectiveness of self-management on adherence to self-care and management of health status elderly people living with hypertension in Pekanbaru City.  Design and methods: This study design was quasi-experimental with a pre-post test with a control group. The self-management intervention was provided through four home visits to elderly people living with hypertension with a caregiver. Samples were taken by the consecutive sampling technique, and a total number 134 elderly people were participants. The instruments used were the adherence to self-care questionnaire and the Short Form 12 Health Survey (SF12) for elderly people. RESULTS: The results showed that most of the respondents with hypertension were 60-74 years of age (84.3%), were female (67.9%), of Minang ethnicity (48.5%), had completed primary school (44%), were unemployed (81.3) %), had a family history of hypertension (50%), were non-smokers (52.2%), and had never drunk alcohol (95.5%). The effects of self-management were positive on adherence to caring for themselves (p<0.001) and on health status (p<0.001). The most influencing factor on self-care compliance and health status after being controlled by confounding variables was self-management (p<0.001). CONCLUSIONS: This study recommends that nursing interventions on self-management for elderly people with hypertension in the community and should be integrated into the Community Health Nurses' (Perkesmas) program in Indonesia. 10.4081/jphr.2021.2406
    Can the implementation of family doctor contracted service enable the elderly to utilize primary health care services more equally? empirical evidence from Shandong, China. BMC primary care BACKGROUND:While the elderly are facing greater health risks, they also face more serious inequalities in utilization of medical services. The family doctor contracted service is the core policy of the Chinese government to cope with aging and to achieve the outcome that everyone has the right to primary health care. However, previous research has neither revealed the degree of inequality in the use of contracted services among the elderly in China, nor has it revealed what factors are related to the inequality in the use of services. OBJECTIVE:Assess and decompose the inequality in the use of family doctors contracted services in the elderly population in China. METHODS:A cross-sectional study of 1037 elderly people was conducted in Shandong Province, China. According to the first consultation rate of family doctors, the physical examination rate, the healthy lifestyle guidance rate and the chronic disease management rate, the situation of elderly people's utilization of family doctor contracted service was investigated. The concentration index is used to measure the degree of inequality in the use of family doctors contracted services by the elderly. In order to test the contribution of different factors to the inequality of utilization of family doctors contracted services, the concentration index was also decomposed. RESULTS:The first consultation rate of family doctors for the elderly in Shandong Province was 24.6%, the physical examination rate was 65.8%, the healthy lifestyle guidance rate was 13.7%, and the chronic disease management rate was 52.2%. The horizontal inequality index of the healthy lifestyle guidance rate and the chronic disease management rate were 0.451 and 0.573, respectively, indicating that there is an inequality of pro-wealth. The concentration index of physical examination rate and chronic disease management rate is negative (- 0.260, - 0.518), which means inequality to the poor. Education level is the most important factor affecting the unequal utilization of health services for the elderly, followed by income. CONCLUSION:The family doctor contracted service has had a positive impact on alleviating the health inequality in the utilization of basic medical and health services for the elderly. Although there is still inequality in terms of pro-wealth for the elderly, the utilization of family doctor contracted service has weakened the inequality of service utilization brought about by income. Enhancing the health literacy of the elderly, narrowing the gap between the rich and the poor, bridging the gap between urban and rural areas, and building a harmonious family relationship can promote the realization of basic medical and health care services for every elderly. 10.1186/s12875-022-01630-0
    A Preliminary Study on Self-Healing and Self-Health Management in Older Adults: Perspectives From Healthcare Professionals and Older Adults in Taiwan. Chu Kuei-Hui,Tung Heng-Hsin,Clinciu Daniel L,Hsu Hua-I,Wu Yi-Chen,Hsu Ching-I,Lin Shu-Wei,Pan Shi-Jun Gerontology & geriatric medicine The human body has tremendous self-healing capacity and regeneration after injuries and pathogen invasions. These factors are particularly important in older adults which take longer to heal and recover physically. In addition to clinical investigations, perspectives from both experts in the field and the living experiences of the general public could play significant roles to enhance the body's healing mechanisms in older adults. A semi-structured interview was conducted which included 15 participants (9 experts and 6 older adults aged 65 years and older). Content analysis with an inductive approach was employed about participants' experiences and perspectives. All participants in this study revealed that self-healing mechanisms can be enhanced through physiological, psychological, and socio-environmental factors. When more of these factors can be integrated into a recovery management plan, it can hasten self-healing in older adults. Social capability has a profound impact on an individual's mental health while oral health and hygiene significantly affect the nutritional intake status. In regards to physical aspects, regular daily activity patterns, nutritious eating, moderate exercise, and sleep quality are significant, while psychological aspects such as cheerfulness, positive attitudes, and good interpersonal relationships can help control chronic diseases. 10.1177/23337214221077788
    'My health is not a job': a qualitative exploration of personal health management and imperatives of the 'new public health'. MacGregor Jennifer C D,Wathen C Nadine BMC public health BACKGROUND:There is an increasing push in Western healthcare for people to 'manage' their health, a key aspect of what has been called the 'new public health'. It has been argued that this 'personal health management' - informal work done to monitor, inform, or influence one's health - may be a burden, with potential to contribute to poor health outcomes. However, there is little research actually examining perceptions of personal health management and the 'burden' of these activities, particularly for generally healthy individuals. METHODS:We conducted exploratory qualitative interviews with 30 generally healthy men and women about their perceptions and experiences of personal health management. Questions focused on health behaviours (e.g., information seeking), as well as feelings about these behaviours and perceptions of the time dedicated to health. Audio-recorded interviews were transcribed and analyzed qualitatively using NVivo 10. Where appropriate, quantitative codes were applied and descriptive statistics are reported alongside qualitative findings. RESULTS:Participants were generally satisfied with the amount of time spent on their health and few perceived personal health management as a burden. Many participants took issue with the concept of 'work' being associated with health and stressed the importance of taking personal responsibility for health. CONCLUSIONS:Our findings suggest that generally healthy people have internalised the notion of the 'new public health' and accepted the imperative of personal health responsibility. On the one hand, this bodes well for healthy individuals; their positive attitude may lead to better health outcomes, and the manageable amount of time spent suggests personal health management is unlikely to cause negative health consequences associated with stress. On the other hand, our findings may indicate that other factors, such as social determinants of health, are ignored in health promotion efforts and that those who cannot manage their own health may fall further behind. Future research should continue to explore the time people spend 'working' for their health, and how they perceive and respond to 'new public health' imperatives. 10.1186/1471-2458-14-726
    Designing and evaluating a patient-centred health management system for seniors. Dhillon Jaspaljeet Singh,Wünsche Burkhard,Lutteroth Christof Journal of telemedicine and telecare INTRODUCTION:Telehealth has been widely promoted as a technology to make healthcare more effective and affordable. However, current telehealth systems suffer from vendor lock-in and high cost, and are designed for managing chronic diseases rather than preventing them. METHODS:We address shortcomings of existing consumer-level health informatics applications in supporting senior health consumers, and provide designers of such systems with a design framework. We assess the feasibility of patient-centred health management systems (HMSs) that are designed based on the proposed framework. In contrast to traditional telehealth, HMSs are patient centred and aim at enabling health consumers to take control of their own health by providing functionality for health self-management. Quantitative and qualitative methods were adopted in evaluating a prototype HMS. RESULTS:Senior healthcare consumers viewed our HMS prototype positively, and experienced a positive change in their attitude towards their health. We identified requirements and challenges for HMSs. In particular, participants indicated that social networking features must have a clear purpose beyond simple broadcasting of emotions and opinions. DISCUSSION:Our study indicates that seniors are able and motivated to leverage a web-based patient-centred HMS, provided that there are suitable health support applications tailored to their needs. This could be achieved by making it attractive for third party application developers to contribute HMS content. 10.1177/1357633X15586082
    [Attaching importance to health of elderly population and promoting national healthy ageing actively in China]. Wang H M Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi China has entered an aging society since 1999. By the end of 2017, the number of persons aged ≥60 years had increased to 240.90 million. At present, the average life expectancy of China's population is 76.4 years, and the healthy life expectancy is around 68.7 years, which means that the elderly will be accompanied by disease for about 8 years. The main health problems of the elderly in China include increased prevalence of chronic diseases, increased prevalence of disability, insufficient attention to older persons' mental health and area specific differences in the health level of the elderly. The disease status of the elderly cannot be ignored. Strengthening the medical services in western and rural areas, emphasizing the psychological and mental concern for the elderly, formulating unified health evaluation criteria, promoting a new model of medical and nursing care combination, establishing an elderly security system with equal responsibilities and rights, jointly managing under the cooperation of whole society and multi-dimensions to protect the health of the elderly are essential to the construction of an active ageing society in China and the realization of the strategic goal of healthy China. 10.3760/cma.j.issn.0254-6450.2019.03.002
    Health Risk Assessment Indicators for the Left-Behind Elderly in Rural China: A Delphi Study. Luo Ruzhen,Zhang Chunmei,Liu Yanhui International journal of environmental research and public health In China, many young and middle-aged rural residents move to urban areas each year. The rural elderly are left behind. The number of the rural left-behind elderly is increasing with urbanization, but it is unclear which indicators can be used to assess their health condition. The health risk assessment index system was developed to improve the health level of the rural left-behind elderly. A two-round web-based Delphi process was used to organize the recommendations from fifteen Chinese experts in geriatrics, health management, social psychology who participated in this study. Meaningfulness, importance, modifiability, and comprehensive value of the health risk assessment indicators in the index system were evaluated. The effective recovery rates of the two-round Delphi were 86.67% and 92.31%, respectively. The judgement coefficient and the authority coefficient were 0.87 and 0.82, respectively. The expert familiarity was 0.76. Ultimately, the health risk assessment index system for the rural left-behind elderly consisted of five first-level indicators, thirteen second-level indicators, and sixty-six third-level indicators. The final indicators can be used to evaluate the health of the rural left-behind elderly and provide the basis for additional health risk interventions. 10.3390/ijerph17010340
    Analysis of the Effect of Health Management of Chronic Diseases and Metabolic Disorders under the Guidance of B-Ultrasound. Luo Xiu,Wang Yi Journal of healthcare engineering Chronic diseases are diseases with insidious onset, prolonged duration, and intractability and are associated with complex etiology and multiple morbidities, including hypertension, obesity, liver disease, kidney disease, cancer, cardiovascular disease, and chronic lung disease. For patients with chronic diseases, although the cause of the disease is not in the spleen and stomach, medication or further development of the disease will affect the function of the spleen and stomach disorders, leading to worsening of the disease. In this article, ultrasound is used to detect health disorders of the spleen and stomach. Patients should eat a light diet and exercise more. Elderly patients can increase abdominal massage and other health care. It should be emphasized that the prevalence of chronic diseases is not lower in people with high education or high economic income but is closely related to people's daily living habits; secondly, we should enhance physical exercise and advocate annual physical examination. Finally, we need to develop different measures according to different regions to prevent and treat chronic diseases and give timely feedback to the interventions. New preventive and curative measures are given in time to improve public health. 10.1155/2021/6648611
    How Do Intergenerational Economic Support, Emotional Support and Multimorbidity Affect the Catastrophic Health Expenditures of Middle-Aged and Elderly Families?-Evidence From CHARLS2018. Frontiers in public health Objectives:The elderly face multiple vulnerabilities such as health, economy and society, and are prone to catastrophic health expenditures. This study aims to analyze the impact of children's intergenerational economic support, emotional support, and illness on the catastrophic health expenditures of middle-aged and elderly families. Methods:Using China Health and Retirement Longitudinal Study (CHARLS 2018) data to calculate the catastrophic health expenditure of Chinese households as the dependent variable. Taking children's intergenerational economic support, emotional support and multimorbidity as core independent variables, gender, age, marital status, medical insurance and other variables as control variables, and perform logistic regression analysis. According to the heterogeneity analysis of age and gender, the impact of intergenerational economic support, emotional support and multimorbidity on the catastrophic health expenditure of middle-aged and elderly families is explored. Results:When catastrophic health expenditures occur in middle-aged and elderly families, the children's intergenerational economic support will increase significantly, especially in families with members aged 60-74. Children's emotional support can effectively reduce the risk of catastrophic health expenditures for middle-aged and elderly families. Compared with children's intergenerational economic support and emotional support, the impact of multimorbidity on the catastrophic health expenditures of middle-aged and elderly families is the most significant. Suffering from multimorbidity can increase the risk of catastrophic health expenditures for middle-aged and elderly families, especially families with male members suffering from multiple diseases. Conclusions:It is recommended that we should do a good job in popularizing the knowledge of chronic diseases to minimize the occurrence of multimorbidity. The government should establish group medical insurance related to chronic disease diagnosis. According to the severity of the disease or the special circumstances of the patient, the level of medical insurance reimbursement is divided in detail, especially for chronic disease clinics and drug reimbursement. Children should be encouraged to strengthen the emotional connection and effective care of the elderly, focusing on the elderly 60-74 years old, in order to reduce their care pressure and maintain the physical and mental health of the elderly. 10.3389/fpubh.2022.872974
    A study on Yangsaeng (health management) of Korean older adults by 4 constitution types. Kim Jeong Suk,Sok Sohyune R Holistic nursing practice This study examined and compared the level of Yangsaeng (health management) of the Korean older adults by 4 constitution types. The study was a cross-sectional design. The participants were 189 elderly participants in South Korea. Data were collected using a demographic characteristics form, 4 Constitution Types Scale and Yangsaeng (health management) Scale. In findings, first, the level of Yangsaeng (health management) of lesser yang person was significantly better than those of greater yin person and lesser yin person. Second, greater yin person scored the highest in moral and sexual life Yangsaeng (health management), lesser yang person scored the highest in mind and diet Yangsaeng (health management), and lesser yin person scored the highest in activity and rest, sleep, and seasonal health Yangsaeng (health management). 10.1097/HNP.0b013e31826ed0ff
    Routine self-tracking of health: reasons, facilitating factors, and the potential impact on health management practices. Figueiredo Mayara,Caldeira Clara,Chen Yunan,Zheng Kai AMIA ... Annual Symposium proceedings. AMIA Symposium Despite a growing interest in self-tracking of one's health, what factors lead to self-tracking routinely (i.e., collecting data at regular intervals), and the effects of this behavior, remain largely understudied. Using data from the Pew Survey on Tracking for Health, we examined the patterns of self-tracking activity to understand reasons for this behavior and its impact on health management practices. We tested multiple logistic regression models to assess the influence of different predicting variables, and to find whether routine self-tracking leads to positive change to one's approaches to health management. Our results suggest that recent visits to emergency care and the type(s) of tracking tools used are significant predictors of routine self-tracking activities. Further, the results suggest that routine self-tracking, as opposed to occasional, event-triggered tracking, is more likely to result in positive changes to health management approaches. Our findings also highlight barriers to and opportunities for designing useful and usable tools to facilitate self-tracking and empower patients to become more proactive in managing their own health.
    Distinct Activities for Medical Practices Providing Population Health Management for Older Adults. Arenas Marc A,Weiss Carlos O Population health management 10.1089/pop.2020.0016
    Adoption of online health management tools among healthy older adults: An exploratory study. Zettel-Watson Laura,Tsukerman Dmitry Health informatics journal As the population ages and chronic diseases abound, overburdened healthcare systems will increasingly require individuals to manage their own health. Online health management tools, quickly increasing in popularity, have the potential to diminish or even replace in-person contact with health professionals, but overall efficacy and usage trends are unknown. The current study explored perceptions and usage patterns among users of online health management tools, and identified barriers and barrier-breakers among non-users. An online survey was completed by 169 computer users (aged 50+). Analyses revealed that a sizable minority (37%) of participants use online health management tools and most users (89%) are satisfied with these tools, but a limited range of tools are being used and usage occurs in relatively limited domains. Improved awareness and education for online health management tools could enhance people's abilities to remain at home as they age, reducing the financial burden on formal assistance programs. 10.1177/1460458214544047
    A Proactive Mobile Health Application Program for Promoting Self-Care Health Management among Older Adults in the Community: Study Protocol of a Three-Arm Randomized Controlled Trial. Wong Arkers Kwan Ching,Wong Frances Kam Yuet,Chang Katherine Ka Pik Gerontology BACKGROUND:The use of mobile health (mHealth) has become common in recent years and is regarded as one of the most effective interventions for developing disease-specific management skills and establishing confidence in making preventive health behavior changes and accomplishing health-related goals among community-dwelling older adults. Most mHealth designs adopt a reactive care approach whereby health care professionals do not respond until they receive abnormal assessment results from the database or a message or signal from the client. The purpose of this study is to determine the effectiveness of a proactive mobile health application program with the support of a community health-social care team for older adults dwelling in the community on improving their self-care health management. METHODS:This is a three-armed, randomized controlled trial. The study will be conducted in 7 community centers with an estimated sample size of 282 participants. The participants will be randomly assigned to mHealth with interactivity, mHealth, and control groups when they are (1) aged 60 or above, (2) complaining chiefly of pain, hypertension, or diabetes mellitus, (3) living within the service areas, and (4) smartphone users. Subjects in the mHealth with interactivity group will receive 2 main elements, the mHealth application and nurse case management supported by a social service team. The mHealth group will receive the mHealth application only. The primary outcome measure will be self-efficacy, and secondary outcomes will include self-management outcomes (pain score, blood pressure, capillary blood glucose), client outcomes (quality of life, depression), and health service utilization outcomes (institutionalization and health service utilization [general practitioner, outpatient clinic, emergency room, hospital admission]). Data will be collected before intervention, after intervention, and 3 months after intervention. DISCUSSION:The incremental benefits of adding interactivity in the mHealth program have not been confirmed. This present study will add valuable information to the knowledge gap of whether mHealth with nurse interaction supported by a health-social partnership can improve self-care management among community-dwelling older adults. 10.1159/000509129
    The effect of older-person centered and integrated health management model on multiple lifestyle behaviors: A randomized controlled trial from China. Zhang Man,Chao Jianqian,Li Dan,Gu Jiayi,Chen Wenji,Xu Hui,Hussain Mubashir,Wu Wenjuan,Deng Lin,He Tingting,Zhang Ruizhi Archives of gerontology and geriatrics OBJECTIVE:To investigate the effectiveness of the older-centered Integrated Health Management Model Project (OPCHMP) for multiple lifestyle behaviours in the elderly. METHODS:A 2-arm, parallel, randomized controlled trial was conducted in Nanjing. The elderly were recruited from multiple community health service centres. The intervention group was intervened and received a personalized, 2-year OPCHMP. The control group only received usual care. Adherence to healthy lifestyle behaviours (ATHLBS) is the primary outcome, obtained through a self-reported composite health behaviour score. The secondary outcomes were health indicators. General estimating equation models were performed to analyse longitudinal dichotomous data and continuous data. RESULTS:637 (intervention = 323; control = 314) participants were included in the study. The participants mean age was 70.53 ± 6.07 years. Significant ATHLBS correction was achieved after 24-month follow-up in the intervention group, comparing to controls. And the intervention group reported significantly better health indicators. CONCLUSION:OPCHMP had positive effect on multiple lifestyle habits in elderly population, which is very encouraging. 10.1016/j.archger.2018.07.012
    Research on the application of health management model based on the perspective of mobile health. Yang Yan,Tian Cui-Huan,Cao Juan,Huang Xue-Jie Medicine The aim of the present study was to explore the application and its effect of mobile medical treatment to chronic disease health management in physical examination population, and to provide references for comprehensive intervention and management of chronic diseases.From January to December 2016, 300 medical examiners in a general hospital health management center were randomly divided into health management group (155 cases) and control group (145 cases). The control group completed routine physical examination and health-risk assessment and provided corresponding reports, repeated annual physical examination and health-risks assessment. In addition to the routine physical examination and health-risk assessment, the health management group reminded the examiners to pay attention to their lifestyle and dietary habits by moving online and offline dynamic health interventions and provide targeted guidance for high-risk population such as diabetes, obesity, hypertension, etc. A review was made after 2 years. The clinical indexes and chronic disease behavior of patients before and after management were compared, and the effect was evaluated by statistical analysis.After management, all the clinical indexes were significantly improved, and the patients' dietary structure, bad living habits, psychologic state, and other chronic disease behaviors were obviously improved. The proportion of patients with high risk of hypertension, diabetes, and obesity in health management group was significantly lower than that before intervention and control group (P < .05).Using mobile network online, offline dynamic health intervention model can reduce the risk of common chronic diseases in health management objects, this health management model of chronic disease is worth popularizing. 10.1097/MD.0000000000016847
    Influence of health promoting lifestyle on health management intentions and behaviors among Chinese residents under the integrated healthcare system. Zhou Chi,Zheng Weijun,Tan Fang,Lai Sihong,Yuan Qi PloS one BACKGROUND:Health promoting lifestyle is an important influencing factor of individual health status. This study aims to assess the health promoting lifestyle of community residents in China, and explore its association with their health management intention and behaviors during the integrated healthcare system reform. METHODS:A total of 666 residents were recruited from six county level hospitals and 12 community health centers from July to August 2019 in Zhejiang Province, China. Health promoting lifestyle was measured by the Chinese version Health Promoting Lifestyle Profile-II scale (HPLP-II). RESULTS:The average total score of HPLP-II among our sample was 130.02±23.19. Among the six domains, interpersonal relationship had the highest average score (2.68±0.50), and physical activity scored the lowest (2.21±0.59). Total score of HPLP-II scale was negatively associated with being male (β = -0.13, p<0.01; Ref: female), positively associated with being students (β = 0.15, p<0.01; Ref: self-employed), and positively associated with a monthly per capita income of more than 8000 RMB (β = 0.15, p<0.01; Ref: less than 3000 RMB). The domain scores of HPLP-II were significantly correlated with residents' health management intention and their behavior on following doctors' advice or not. CONCLUSIONS:The health promoting lifestyles of community residents in China are at moderate levels. Improving residents' healthy lifestyle levels might be helpful for changing their health management intentions or behaviors. 10.1371/journal.pone.0263004
    The effect of community-based health management on the health of the elderly: a randomized controlled trial from China. Chao Jianqian,Wang Yimin,Xu Hui,Yu Qing,Jiang Lili,Tian Lin,Xie Wenyuan,Liu Pei BMC health services research BACKGROUND:An aging population poses significant challenges to health care in China. Health management has been implemented to reduce the costs of care, raise health service utilization, increase health knowledge and improve quality of life. Several studies have tried to verify the effectiveness of health management in achieving these goals worldwide. However, there have been insufficient randomized control trials (RCTs) to draw reliable conclusions. The few small-scale studies conducted in China include mostly the general population rather than the elderly. Our study is designed to evaluate the impact of community-based health management on the health of the elderly through an RCT in Nanjing, China. METHODS:Two thousand four hundred participants, aged 60 or older and who gave informed consent, were randomly allocated 1:1 into management and control groups, the randomization schedule was concealed from community health service center staff until allocation. Community-based health management was applied in the former while the latter was only given usual care. After 18 months, three categories of variables (subjective grading health indices, objective health indices and health service utilization) were measured based on a questionnaire, clinical monitoring and diagnostic measurements. Differences between the two groups were assessed before and after the intervention and analyzed with t-test, χ2-test, and multiple regression analysis. RESULTS:Compared with the control group, the management group demonstrated improvement on the following variables (P<0.01): health knowledge score, self-evaluated psychological conditions, overall self-evaluated health conditions, diet score, physical activity duration per week, regular blood pressure monitoring, waist-to-hip ratio, systolic blood pressure and fasting blood sugar. The number of outpatient clinic visits did not differ significantly (P=0.60) between the two groups before intervention, while after intervention it was smaller in the management group than in the control group (P<0.01). However, the number of hospital admissions in the preceding 6 months was not different between the two groups even after intervention (P=0.36). Multiple regression analysis showed that gender, age, education level, chronic disease status and self-evaluated psychological conditions were important factors affecting health knowledge score, BMI, and waist-to-hip ratio. CONCLUSION:Community-based health management improved both subjective grading health indices, objective health indices and decreased the number of outpatient clinic visits, demonstrating effectiveness in improving elderly health. TRIAL REGISTRATION:ChiCTR-OCH-11001716. 10.1186/1472-6963-12-449
    The effect of integrated health management model on the satisfaction among Chinese elderly. Chao Jianqian,Xie Wenyuan,Yang Yingchun,Liu Heng,Jiang Lili,Liu Pei Archives of gerontology and geriatrics The study objective was to investigate the effect of integrated health management model on the satisfaction among Chinese elderly. Using a randomized controlled trial, 600 people who are 60 and over have signed the informed consent in China were randomly assigned into management and control group. The management group received care integrated individual health management with community health management model in the follow-up 6 months. The individual health management included establishing health record, performing health evaluation, giving individual instruction, carrying out telephone consultation and follow-up. The community health management includes lectures on health knowledge, distribution of health education materials and physical fitness exercise kit. Factor analysis, t-test, χ(2)-test and logistic regression models were used. The average satisfaction scores of baseline and final of management or control group were calculated through factor analysis. The management group has shown a significant improvement in satisfaction score, no difference in control group. Logistic regression analysis of influencing factors of the elderly satisfaction showed that the satisfaction score of male, individuals without chronic disease and management group was higher. These results suggest that integrated health management model can improve the elderly satisfaction in China through realizing good communication between the elderly and medical staff in community. 10.1016/j.archger.2013.01.003
    Evaluating the Effectiveness of the Health Management Program for the Elderly on Health-Related Quality of Life among Elderly People in China: Findings from the China Health and Retirement Longitudinal Study. Hao Xiuqi,Yang Yuehan,Gao Xiaotong,Dai Tao International journal of environmental research and public health The world's rapidly aging population brings serious challenges which could be addressed by changes in behaviour and policy that promote good health in older age. However, these cheap and simple interventions are not available in many countries. China is one of the fastest-ageing countries in the world. The health management programs for the elderly in basic public health services was introduced by the government to promote the health of the elderly in China and address the challenges related to ageing. However, the effectiveness of the program is uncertain. So, we use a propensity score matching difference-in-difference (PSM-DID) model to analyse the causal effect of the health management program for the elderly in basic public health services on the health-related quality of life (HRQoL) of the elderly in China. The result shows that the program has improved the physical health of the elderly but has had no significant impact on mental health. Expanding the program to cover mental health could further benefit the HRQoL of the elderly. The program is a cost-effective approach to tackle the challenges of ageing and is a good example for other developing countries facing the same ageing challenges. 10.3390/ijerph16010113
    Examining inequality in utilisation of health management services for the elderly in rural Henan China. Wu Huan,Liu Yaqing BMC health services research BACKGROUND:The health management plays an important role in improving the quality of life of the elderly and relieving the pressure of health resource consumption. This study aims to assess the income-related inequality in utilisation of health management services (HMS) for the elderly and the contribution of the related factors to inequality in rural Henan China. METHODS:The data from 2015 Henan Rural Residents Health Survey with 1403 elderly people as the final sample were used for analysis. The concentration index (CI) was used to measure inequality in HMS utilisation for the elderly (no HMS, health assessment, physical examination, auxiliary examination, and health guidance). The decomposition of CI was adopted to explain the contribution of various determinants to inequality in HMS utilisation for the elderly. RESULTS:No HMS utilisation was disproportionately concentrated among the poor (CI = - 0.0730, p = 0.0155), utilisation of physical and auxiliary examination was disproportionately concentrated among the rich (CI = 0.0575, p = 0.0448; CI = 0.0811, p = 0.0044). In addition, the pro-poor effects of health assessment and guidance utilisation were not statistically significant (CI = - 0.0173, p = 0.4617; CI = - 0.0213, p = 0.3900). The results of CI decomposition revealed that household income and family size made positive contributions to inequality while social medical insurance, gender, marital status, and age made negative contributions to inequality. The improved service satisfaction with village clinics could reduce inequality in HMS utilisation, while the improved service satisfaction with township hospitals could increase inequality in HMS utilisation. CONCLUSIONS:Although HMS for the elderly is provided free of charge, its accessibility remains pro-rich due to various factors. Policy makers should adopt effective interventions to resolve the contradiction between these factors and the utilisation of HMS, and redress inequality in the utilisation of HMS. 10.1186/s12913-020-05630-7
    Twelve Smartphone Applications for Health Management of Older Adults during the COVID-19 Pandemic. Ha Seong Kyu,Lee Hey Sig,Park Hae Yean International journal of environmental research and public health This study investigated smartphone applications that may be helpful in managing the health of the elderly during COVID-19. The application searched the seven areas of health management, newly classified in OTPF 4th edition with keywords in the Google Play Store. As a result, two applications meeting the selection criteria were selected for each area. The selected applications are social and emotional health promotion and maintenance: , symptom and condition management: , communication with the health care system: , medication management: , physical activity: , nutrition management: Through the analyzed applications, twelve applications with the potential to improve the health management and quality of life in older adults during social distancing or self-isolation due to COVID-19 were identified. 10.3390/ijerph181910235
    Study on the Types of Elderly Intelligent Health Management Technology and the Influencing Factors of Its Adoption. Chen Zhu,Qi Huiying,Wang Luman Healthcare (Basel, Switzerland) [Background]: In recent years, aging has become a global social problem. Intelligent health management technology (IHMT) provides solutions for the elderly to deal with various health risks. However, the elderly are facing many difficulties in using IHMT. Studying the application types of IHMT and the influencing factors of the elderly's acceptance of it will help to improve the use behavior of the elderly. [Methods]: This paper summarizes the application types of IHMT, identifies the influencing factors of the elderly's adaption of IHMT, and makes a systematic comment on the influencing factors. [Results]: We divide the different functions of IHMT for the elderly into four types: self-monitoring, medical care, remote monitoring, and health education. The influencing factors are divided into three types: individual, social, and technology. [Conclusions]: This study finds that IHMT's application covers all aspects of the health services of the elderly. Among these applications, self-monitoring is the most used. We divided the influencing factors of the elderly's acceptance of IHMT into three categories and nine subcategories, having 25 variables. 10.3390/healthcare9111494