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The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions
BACKGROUND: This study introduces the conceptual basis and operational measure, of BioPyschoSocial (BPS) health and related risk to better understand how well older people are managing and to screen for risk status. The BPS Risk Screener is constructed to detect vulnerability at older ages, and seek...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816546/ https://www.ncbi.nlm.nih.gov/pubmed/29454316 http://dx.doi.org/10.1186/s12877-018-0739-x |
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author | Hildon, Zoe J.-L. Tan, Chuen Seng Shiraz, Farah Ng, Wai Chong Deng, Xiaodong Koh, Gerald Choon Huat Tan, Kelvin Bryan Philp, Ian Wiggins, Dick Aw, Su Wu, Treena Vrijhoef, Hubertus J. M. |
author_facet | Hildon, Zoe J.-L. Tan, Chuen Seng Shiraz, Farah Ng, Wai Chong Deng, Xiaodong Koh, Gerald Choon Huat Tan, Kelvin Bryan Philp, Ian Wiggins, Dick Aw, Su Wu, Treena Vrijhoef, Hubertus J. M. |
author_sort | Hildon, Zoe J.-L. |
collection | PubMed |
description | BACKGROUND: This study introduces the conceptual basis and operational measure, of BioPyschoSocial (BPS) health and related risk to better understand how well older people are managing and to screen for risk status. The BPS Risk Screener is constructed to detect vulnerability at older ages, and seeks to measure dynamic processes that place equal emphasis on Psycho-emotional and Socio-interpersonal risks, as Bio-functional ones. We validate the proposed measure and describe its application to programming. METHODS: We undertook a quantitative cross-sectional, psychometric study with n = 1325 older Singaporeans, aged 60 and over. We adapted the EASYCare 2010 and Lubben Social Network Scale questionnaires to help determine the BPS domains using factor analysis from which we derive the BPS Risk Screener items. We then confirm its structure, and test the scoring system. The score is initially validated against self-reported general health then modelled against: number of falls; cognitive impairment; longstanding diseases; and further tested against service utilization (linked administrative data). RESULTS: Three B, P and S clusters are defined and identified and a BPS managing score (‘doing’ well, or ‘some’, ‘many’, and ‘overwhelming problems’) calculated such that the risk of problematic additive BPS effects, what we term health ‘loads’, are accounted for. Thirty-five items (factor loadings over 0.5) clustered into three distinct B, P, S domains and were found to be independently associated with self-reported health: B: 1.99 (1.64 to 2.41), P: 1.59 (1.28 to 1.98), S: 1.33 (1.10 to 1.60). The fit improved when combined into the managing score 2.33 (1.92 to 2.83, < 0.01). The score was associated with mounting risk for all outcomes. CONCLUSIONS: BPS domain structures, and the novel scoring system capturing dynamic BPS additive effects, which can combine to engender vulnerability, are validated through this analysis. The resulting tool helps render clients’ risk status and related intervention needs transparent. Given its explicit and empirically supported attention to P and S risks, which have the potential to be more malleable than B ones, especially in the older old, this tool is designed to be change sensitive. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0739-x) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-5816546 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-58165462018-02-21 The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions Hildon, Zoe J.-L. Tan, Chuen Seng Shiraz, Farah Ng, Wai Chong Deng, Xiaodong Koh, Gerald Choon Huat Tan, Kelvin Bryan Philp, Ian Wiggins, Dick Aw, Su Wu, Treena Vrijhoef, Hubertus J. M. BMC Geriatr Research Article BACKGROUND: This study introduces the conceptual basis and operational measure, of BioPyschoSocial (BPS) health and related risk to better understand how well older people are managing and to screen for risk status. The BPS Risk Screener is constructed to detect vulnerability at older ages, and seeks to measure dynamic processes that place equal emphasis on Psycho-emotional and Socio-interpersonal risks, as Bio-functional ones. We validate the proposed measure and describe its application to programming. METHODS: We undertook a quantitative cross-sectional, psychometric study with n = 1325 older Singaporeans, aged 60 and over. We adapted the EASYCare 2010 and Lubben Social Network Scale questionnaires to help determine the BPS domains using factor analysis from which we derive the BPS Risk Screener items. We then confirm its structure, and test the scoring system. The score is initially validated against self-reported general health then modelled against: number of falls; cognitive impairment; longstanding diseases; and further tested against service utilization (linked administrative data). RESULTS: Three B, P and S clusters are defined and identified and a BPS managing score (‘doing’ well, or ‘some’, ‘many’, and ‘overwhelming problems’) calculated such that the risk of problematic additive BPS effects, what we term health ‘loads’, are accounted for. Thirty-five items (factor loadings over 0.5) clustered into three distinct B, P, S domains and were found to be independently associated with self-reported health: B: 1.99 (1.64 to 2.41), P: 1.59 (1.28 to 1.98), S: 1.33 (1.10 to 1.60). The fit improved when combined into the managing score 2.33 (1.92 to 2.83, < 0.01). The score was associated with mounting risk for all outcomes. CONCLUSIONS: BPS domain structures, and the novel scoring system capturing dynamic BPS additive effects, which can combine to engender vulnerability, are validated through this analysis. The resulting tool helps render clients’ risk status and related intervention needs transparent. Given its explicit and empirically supported attention to P and S risks, which have the potential to be more malleable than B ones, especially in the older old, this tool is designed to be change sensitive. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12877-018-0739-x) contains supplementary material, which is available to authorized users. BioMed Central 2018-02-17 /pmc/articles/PMC5816546/ /pubmed/29454316 http://dx.doi.org/10.1186/s12877-018-0739-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Hildon, Zoe J.-L. Tan, Chuen Seng Shiraz, Farah Ng, Wai Chong Deng, Xiaodong Koh, Gerald Choon Huat Tan, Kelvin Bryan Philp, Ian Wiggins, Dick Aw, Su Wu, Treena Vrijhoef, Hubertus J. M. The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title | The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title_full | The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title_fullStr | The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title_full_unstemmed | The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title_short | The theoretical and empirical basis of a BioPsychoSocial (BPS) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
title_sort | theoretical and empirical basis of a biopsychosocial (bps) risk screener for detection of older people’s health related needs, planning of community programs, and targeted care interventions |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5816546/ https://www.ncbi.nlm.nih.gov/pubmed/29454316 http://dx.doi.org/10.1186/s12877-018-0739-x |
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