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We aimed to document in primary care older adults the relationship between family violence (FV) and mental and physical health, satisfaction with life, and health service use, by gender. The study sample included data from 1,658 older adults recruited in primary care practices, in one of the largest health regions in the province of Quebec. The presence of FV (partner/spouse, adult child) was assessed with the 21-item Family Violence Scale (FVS) adapted from the conflicts Tactics Scale 2. Self-rated mental health (SRMH) and self-rated physical health (SRPH) were assessed with single-item measures. Satisfaction with life (SWL) was measured using a validated French version of the SWL scale. Health service use over a 2-year period included outpatient consultations (number), emergency department (ED) visits (yes/no), and hospitalizations (yes/no). Multi-level logistic and Poisson's regression models were conducted to assess study outcomes as a function of FV. Analyses were stratified by perpetrator and gender. There was an association between FV and SRMH in women (OR = 0.41, 95% CI = [0.27, 0.62]), and SWL in both men and women (B = −5.74, 95% CI = [–6.71, –4.76]; B = −10.07, 95% CI = [–14.16, –5.98], respectively). Significant associations were found in women between FV and ED visits (OR = 1.45, 95% CI = [1.12, 1.18]), hospitalizations (OR = 1.36, 95% CI = [1.32, 1.43]), and outpatient consultations (RR = 1.25, 95% CI = [1.19, 1.30]). SWL moderated the association between FV and likelihood of hospitalization. Gender differences were observed between FV and SRMH and SWL. FV was associated with increased health service use in women but not men. These gender differences may suggest stigma-related barriers to health service use. Victims of violence with higher SWL had a lower likelihood of being hospitalized. Public health programs aimed at increasing awareness of the different types of FV and interventions aiming to improve resilience in victims are needed. [ABSTRACT FROM AUTHOR]

Objectives: The aims of this study are to assess in a sample of older adults consulting in primary care practices the determinants and quality of life associated with post-traumatic stress syndrome (PTSS). Method: Data used came from a large sample of 1765 community-dwelling older adults who were waiting to receive health services in primary care clinics in the province of Quebec. PTSS was measured with the PTSS scale. Socio-demographic and clinical characteristics were used as potential determinants of PTSS. Quality of life was measured with the EuroQol-5D-3L (EQ-5D-3L) EQ-Visual Analog Scale and the Satisfaction With Your Life Scale. Multivariate logistic and linear regression models were used to study the presence of PTSS and different measures of health-related quality of life and quality of life as a function of study variables. Results: The six-month prevalence of PTSS was 11.0%. PTSS was associated with age, marital status, number of chronic disorders and the presence of an anxiety disorder. PTSS was also associated with the EQ-5D-3L and the Satisfaction with Your Life Scale. Conclusion: PTSS is prevalent in patients consulting in primary care practices. Primary care physicians should be aware that PTSS is also associated with a decrease in quality of life, which can further negatively impact health status. [ABSTRACT FROM AUTHOR]

Objectives To identify the determinants of antihypertensive medication adherence in community-living elderly adults. Design Longitudinal observational study. Setting Population-based health survey in the province of Quebec, Canada. Participants Data from a representative sample (N = 2,811) of community-dwelling adults in Quebec aged 65 and older participating in the Étude sur la Santé des Aînés study. The final study sample analyzed consisted of 926 participants taking antihypertensive drugs during the 2 years of the study. Measurements Adherence to antihypertensive medication was measured using days of supply obtained during a specified time period. Depression and anxiety disorders were assessed using Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria, and physical health status was measured using the Charlson Comorbidity Index. Other factors considered were age, education, marital status, annual family income, and number of antihypertensive drugs that participants used. Results Mean antihypertensive proportion (percentage) of days supplied in was 92.5% in Year 1 and 59.4% in Year 2. The presence of depression and anxiety disorders and the number of antihypertensive medications significantly predicted medication adherence. The sex by depression and anxiety disorders interaction term was significant. Conclusion Adherence to antihypertensive medication was significantly associated with depression and anxiety disorders in men but not women. The treatment of depression and anxiety disorders in individuals with hypertension may be helpful in improving medication adherence rates and healthcare outcomes. [ABSTRACT FROM AUTHOR]