Archives of Hellenic Medicine

Last update:

21-Apr-2019

Arch Hellen Med, 37(3), May-June 2019, 374-382

ORIGINAL PAPER

Assessment of the health needs of elderly people in a rural area of Crete:
Contribution to the organization of primary health care services

I. Stefanaki,^1,2 M. Linardakis,² C. Lionis²
¹Embaros Rural Surgery, Health Center of Viannos, Heraklion, Crete,
²Clinic of Social and Family Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece

OBJECTIVE To assess the health status of a cohort of elderly people living in a rural district of Crete. This paper reports the preliminary results of the present study.

METHOD An observational study was conducted on subjects aged 65 years and over living in 4 rural villages, of whom 600 were eligible and 411 (179 men and 232 women) participated. Data on the medical and family history were recorded and a standardized physical examination was conducted on each participant. Cognitive and mood disorders were assessed by the Geriatric Depression Scale (GDS) and the Mini Mental State Examination (MMSE). Urinary incontinence in women was assessed using a specific questionnaire. The quality of life (QoL) of the elderly participants and their orientation to life was evaluated by using self-completed questionnaires that have been validated in the Greek language, the Quality of Well Being (QWB-SA) scale and the Sense of Coherence (SOC) scale. The dependency of their daily life activities was assessed using the Barthel index.

RESULTS Of the 411 participants, 175 (42.7%) were aged ≥75 years, and had a good cognitive status (mean MMSE score 25.2±4.3; p<0.001) and a high level of independence according to the Barthel index (mean 96.9±8). Hypertension was found in 182 subjects (55.8%), musculoskeletal disorders in 28.2%, diabetes mellitus (DM) in 21.2%, and chronic obstructive pulmonary disease (COPD) in 14.4%. Mood disorders were more frequent among the women (GDS=4.6 versus 3.2; p<0.001), and the men presented higher SOC scores than the women (128.2 versus 117.9; p=0.032). The most important behavioral risk factors were found to be physical inactivity (73%), obesity, and low consumption of fruit and vegetables (22.8%). A higher prevalence of smoking was recorded in the men (36.0% versus 4.4%; p<0.001).

CONCLUSIONS This observational study made a contribution to standardization of the organization and implementation of a health needs assessment program in the rural primary care setting. Constructing a database of the diseases and the needs of the elderly will aid health policy makers to plan prevention programs and to promote primary health care in isolated areas.

Key words: Elderly people, Needs assessment, Primary care, Risk factors, Rural area.