RESUMEN
BACKGROUND: The increasing older adult population includes people with disabilities facing added challenges of aging. The Affordable Care Act Section 4103 calls for an annual health risk appraisal (HRA) to be administered with older adults. HRAs show promise when used with older adults, yet little is known about their use with adults aging with acquired disabilities. OBJECTIVES: 1) Explore psychometrics of the multidimensional Stay Well and Healthy! Health Risk Appraisal tool (SWH-HRA) among persons aging with disabilities acquired in early or mid-life, and 2) Assess SWH-HRA application to characterize disability subgroup differences. METHODS: Psychometric analysis conducted on SWH-HRA interview data collected with 93 participants with an acquired disability of at least five years or more post-onset. ANOVA and Chi-square to explore differences in risks by subgroups identified by etiology (traumatic brain injury, stroke, spinal cord injury, and movement disorders). RESULTS: A high prevalence of health risks was noted. Risks were associated with health, participation and quality of life outcomes. With the exception of independence in basic activities of daily living and incontinence, few statistically significant differences were noted among disability subgroups. Patterns of risk clusters and prevalence within disability subgroup were consistent with findings in the literature. CONCLUSION: The SWH-HRA provides a valid and comprehensive health risk assessment. When used in annual wellness visits among persons with disabilities, it has the potential to inform the partnership between health providers and individuals with disabilities as they collaborate to promote healthy aging.
Asunto(s)
Envejecimiento , Lesiones Encefálicas , Personas con Discapacidad , Indicadores de Salud , Traumatismos de la Médula Espinal , Accidente Cerebrovascular , Actividades Cotidianas , Análisis de Varianza , Distribución de Chi-Cuadrado , Análisis por Conglomerados , Femenino , Salud , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Esclerosis Múltiple , Enfermedad de Parkinson , Psicometría , Calidad de Vida , Medición de Riesgo/normas , Incontinencia UrinariaRESUMEN
Access to oral health care is essential for promoting and maintaining overall health and well-being, yet oral health disparities exist among vulnerable and underserved populations. While nurses make up the largest portion of the health care work force, educational preparation to address oral health needs of elders and persons with disabilities is limited across nursing curricula. This descriptive study reports on the interdisciplinary development, implementation, and testing of an oral health module that was included and infused into a graduate nursing curriculum in a three-phase plan. Phase 1 includes evaluation of a lecture presented to eight gerontological nurse practitioner (GNP) students. Phase 2 includes evaluation of GNP students' perceptions of learning, skills, and confidence following a one-time 8-hour practicum infused into 80 required practicum hours. The evaluation data show promise in preparing nurse practitioner students to assess and address preventive oral health needs of persons aging with disabilities such that further infusion and inclusion in a course for nurse practitioners across five specialties will implemented and tested in Phase 3.