2.50
Hdl Handle:
http://hdl.handle.net/10755/151821
Type:
Presentation
Title:
Response Shift in Aged Survivors of Acute Illness
Abstract:
Response Shift in Aged Survivors of Acute Illness
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:June, 2001
Author:Mick, Diane, PhD
P.I. Institution Name:University of Rochester
Objective: To test an adapted model of response shift in an aged population who has survived hospitalization for acute illness. Design: A prospective descriptive cohort design will be used. Population, Sample, Setting: Thirty very old subjects (> 75 years) who have been hospitalized for acute illness in a major northeastern United States academic medical center for a period of 24 hours or longer. Concept: When aged persons are confronted with either a life-threatening or chronic illness, they are faced with a need to find ways to adapt to their illness, and to incorporate these temporary or long-lasting effects of health status changes into daily life. Changes in health following hospitalization may profoundly affect well-being. However, in the aftermath of hospitalization, aged persons may experience “response shift”, or a transformation in their idea of what comprises an acceptable level of physical health and functioning. Response shift is an emerging construct regarded as a behavioral mediator of the subjective adaptation process to chronic illness. Response shift may involve true behavioral change (alpha change); it may reflect an individual’s recalibration of internal standards and values (beta change), or it may represent a concept-redefinition (gamma change). Methods: Very old subjects will be evaluated cognitively at the time of hospital admission, and at one-month and three-month intervals following discharge using the Brief MMSE. Perceptions of functional status will be assessed at each timepoint using the MOS SF-36 Standard Version Questionnaire. Chronic illnesses will be quantified via the Charlson Comorbidity Index. Comparisons of retrospective pre-tests (re-evaluations of prior health) and prospective then tests (projected expectations of health) at each time point, via the 10-item Physical Functioning (PF) sub-scale of the SF-36, as well as narrative analysis of subjects’ anecdotal comments, will be utilized to determine whether response shift has taken place. Implications: Testing of this model may demonstrate that, in the presence of response shift, objective measurements of health do not reveal sufficient substantive information on which to base treatment decisions for the very old. Examination of subjective appraisals of post-illness health and function holds potential for understanding the recovery experience, as well as for evaluating such indicators as latent markers of successive decline. Concurrent with this effort, design of restorative interventions, grounded in enhanced understanding of aged persons’ subjective self-appraisals, will help to ensure the health and autonomy that is central to a fulfilling and productive old age.
Repository Posting Date:
26-Oct-2011
Date of Publication:
Jun-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleResponse Shift in Aged Survivors of Acute Illnessen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151821-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Response Shift in Aged Survivors of Acute Illness</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Mick, Diane, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Rochester</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">diane_mick@urmc.rochester.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: To test an adapted model of response shift in an aged population who has survived hospitalization for acute illness. Design: A prospective descriptive cohort design will be used. Population, Sample, Setting: Thirty very old subjects (&gt; 75 years) who have been hospitalized for acute illness in a major northeastern United States academic medical center for a period of 24 hours or longer. Concept: When aged persons are confronted with either a life-threatening or chronic illness, they are faced with a need to find ways to adapt to their illness, and to incorporate these temporary or long-lasting effects of health status changes into daily life. Changes in health following hospitalization may profoundly affect well-being. However, in the aftermath of hospitalization, aged persons may experience &ldquo;response shift&rdquo;, or a transformation in their idea of what comprises an acceptable level of physical health and functioning. Response shift is an emerging construct regarded as a behavioral mediator of the subjective adaptation process to chronic illness. Response shift may involve true behavioral change (alpha change); it may reflect an individual&rsquo;s recalibration of internal standards and values (beta change), or it may represent a concept-redefinition (gamma change). Methods: Very old subjects will be evaluated cognitively at the time of hospital admission, and at one-month and three-month intervals following discharge using the Brief MMSE. Perceptions of functional status will be assessed at each timepoint using the MOS SF-36 Standard Version Questionnaire. Chronic illnesses will be quantified via the Charlson Comorbidity Index. Comparisons of retrospective pre-tests (re-evaluations of prior health) and prospective then tests (projected expectations of health) at each time point, via the 10-item Physical Functioning (PF) sub-scale of the SF-36, as well as narrative analysis of subjects&rsquo; anecdotal comments, will be utilized to determine whether response shift has taken place. Implications: Testing of this model may demonstrate that, in the presence of response shift, objective measurements of health do not reveal sufficient substantive information on which to base treatment decisions for the very old. Examination of subjective appraisals of post-illness health and function holds potential for understanding the recovery experience, as well as for evaluating such indicators as latent markers of successive decline. Concurrent with this effort, design of restorative interventions, grounded in enhanced understanding of aged persons&rsquo; subjective self-appraisals, will help to ensure the health and autonomy that is central to a fulfilling and productive old age.</td></tr></table>en_GB
dc.date.available2011-10-26T11:14:48Z-
dc.date.issued2001-06en_GB
dc.date.accessioned2011-10-26T11:14:48Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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