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Mahesh S, Bharatan I, Miller R. Strengths-based practice in adult social care: Understanding implementation. NIHR OPEN RESEARCH 2024; 4:19. [PMID: 39282471 PMCID: PMC11399757 DOI: 10.3310/nihropenres.13532.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/16/2024] [Indexed: 09/19/2024]
Abstract
Background There has been increasing emphasis towards adopting strengths-based practice (SBP) within adult social care in England. Whilst there is agreement that SBP is the right approach to discharge adult social care duties, there is limited evidence regarding the implementation of SBP. This paper presents findings from the evaluation of the implementation of SBP in fourteen local authorities in one region in England. Methods We employed a mixed methods research design, drawing on data from a scoping review, 36 interviews with practice leaders and two surveys, one with wider adult social care staff and the other, with external organisations like independent care providers and community and voluntary organisations. Our data collection and analysis were guided by two well established implementation theories: the Consolidated Framework for Implementation Research (CFIR) and Normalisation Process Theory (NPT). Interviews were analysed deductively, and surveys were analysed descriptively. Results Local authorities are at different stages in their implementation journey. The Care Act 2014 and support for SBP demonstrated by key professional groups were seen as major drivers for implementing SBP. Whilst SBP resonated with the professional principles of social workers and occupational therapists, staff did not always have the confidence and skills to adapt to SBP. Changing paperwork and recording systems, providing training opportunities to develop staff competencies, establishing new care pathways, genuine co-production, and senior management buy-in were key enablers supporting implementation. Conclusions To successfully implement SBP, a whole system approach that meaningfully collaborates with key professionals across sectors is essential. When implemented well, SBP has the potential to empower individuals by focusing on what matters to them.
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Affiliation(s)
- Sharanya Mahesh
- Department of Social Work and Social Care, University of Birmingham, Birmingham, UK
| | | | - Robin Miller
- Department of Social Work and Social Care, University of Birmingham, Birmingham, UK
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Nakai A, Morioka I. Strengths within the Community Perceived by Older Adults Living Alone in a Semi-Mountainous Rural Region: A Qualitative Study. NURSING REPORTS 2024; 14:829-837. [PMID: 38651476 PMCID: PMC11036247 DOI: 10.3390/nursrep14020064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 04/25/2024] Open
Abstract
It is recommended that health promotion activities in the community focus on residents' strengths. Hence, this study explored the community strengths perceived by older adults living alone in a semi-mountainous rural region of Japan. A qualitative, descriptive approach was used. Content analysis was performed using data obtained through face-to-face interviews. Interview data were coded; codes were classified based on similarity to create subcategories and categories. The strengths within the community, as perceived by older adults living alone in a semi-mountainous rural region, were revealed in four categories related to ten subcategories: "loose connections with others", "active community participation", "close relationships with community professionals", and "familiarity with the living environment". Strengths within the community perceived by older adults living alone in a semi-mountainous rural region were cultivated in an environment formed by their past lives. Utilizing these resources may help support community-based societies in semi-mountainous rural regions where depopulation and aging are expected to continue in the future. This study was not registered.
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Affiliation(s)
- Ai Nakai
- School of Nursing, University of Kochi, Kochi 781-8515, Japan
| | - Ikuharu Morioka
- Graduate School of Health and Nursing Science, Wakayama Medical University, Wakayama 641-0011, Japan;
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De Witte J, Noten S, Vinckers F, Stoop A, Hovenga N, Landeweer E, Van Regenmortel T. "You Needed to Accept the Situation": Resilience of Nursing Home Residents in Times of COVID-19. Can J Aging 2024; 43:75-83. [PMID: 37665004 DOI: 10.1017/s0714980823000399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
The restrictive measures taken by nursing homes during the COVID-19 outbreak in 2020 (e.g., quarantine) may have been important stressors for which residents needed resilience to safeguard their well-being. Based on 30 semi-structured interviews with nursing home residents and close relatives, this study explored the lived experiences with respect to the restrictive measures. The data were collected in psychogeriatric, somatic, and mixed wards in The Netherlands and Flanders, Belgium. The restrictive measures were important stressors for residents, indicated by feelings of loneliness, sadness, and powerlessness. To deal with these measures, residents used various resources, which were determined by factors in the individual (e.g., health), interactional (e.g., possibilities for social interactions) and contextual (e.g. nursing home policy) domains. Because the lived experiences with respect to the restrictive measures seemed to relate to the resilience of nursing home residents, it is crucial to reinforce resources in the individual, interactional, and contextual domains.
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Affiliation(s)
| | - Suzie Noten
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Floor Vinckers
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Annerieke Stoop
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Nina Hovenga
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Elleke Landeweer
- Department of Primary and Long-term Care, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Tine Van Regenmortel
- HIVA KU Leuven, Leuven, Belgium
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Nakai A, Kawamura K, Morioka I. A Review of the Literature on the Regional Strengths Perceived by Older People Living in Local Japanese Communities. SAGE Open Nurs 2024; 10:23779608241233142. [PMID: 38379574 PMCID: PMC10878209 DOI: 10.1177/23779608241233142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 12/28/2023] [Accepted: 01/25/2024] [Indexed: 02/22/2024] Open
Abstract
As a super-aging society, health promotion activities in local Japanese communities are increasingly essential. Developing the health-promotion programs must include the perspective of older people residing in these communities and what they believe to be their regional strengths. This study aimed to clarify the elements of regional strengths perceived by older people living in local Japanese communities from the literature review. Using the internet edition of the Japan Medical Abstracts Society (Ichu-shi), the authors examined papers on Japanese regional residents using relevant keywords. Of 342 considered papers, 14 papers were extracted in this study. As a result, the contents related to the regional strengths perceived by the older people living in the local Japanese community were extracted, classified based on the similarity of the meanings and contents, and then summarized into the elements of the strengths. As the regional strengths, three categories were cited for individual elements: "Actions or behaviors underpinned by experience," "Continuing to live with positivity and vigor," and "Extensive support for the subject and their family." Three categories were cited for environmental elements: "A comfortable environment," "Maintaining intimate and friendly interpersonal relations," and "Support that meets the regional characteristics." Along with individual and environmental elements, support from experts in the region was cited. Hence, it was concluded that the active participation of experts is essential for promoting activities in local communities, and that deepening relationship with older people has the potential to improve their quality of life.
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Affiliation(s)
- Ai Nakai
- Graduate School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan
- School of Nursing, University of Kochi, Kochi, Japan
| | - Kosuke Kawamura
- Graduate School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan
| | - Ikuharu Morioka
- Graduate School of Health and Nursing Science, Wakayama Medical University, Wakayama, Japan
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Wang Y, Xu J, Yang S, Jiang J, Gao J. Exploratory graph analysis on the Connor-Davidson Resilience Scale (CD-RISC) among older adults in China. Sci Rep 2023; 13:19971. [PMID: 37968334 PMCID: PMC10651855 DOI: 10.1038/s41598-023-46854-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 11/06/2023] [Indexed: 11/17/2023] Open
Abstract
It is important for healthy aging to understand resilience in depth. This study aims to examine the dimensional structure underlying the Connor-Davidson Resilience Scale (CD-RISC) among Chinese older adults. Exploratory Graph Analysis (EGA) was used to evaluate the dimensional structure of CD-RISC in two large samples: training sample (n = 11,493) and cross-validation sample (n = 7662). Then, Confirmatory Factor Analysis (CFA) was used to compare the fit of the theoretical dimensions with the EGA dimensions. Finially, Generalized Linear Model was used to examine the association between resilience scores and self-rated health (SRH) after controlling other covariates in order to evaluate the predictive value of the EGA dimensions. The EGA indicated two demensions(named foresight and self-adjustment) of the 25-item CD-RISC. The CFA comparison found that the two-demension structure of CD-RISC fit significantly better than the theoretical three-demension structure. After controlling for sociodemographic characteristics, generalized linear model showed that the EGA dimensions has better protective value with SRH. Compared with older adults with lowest quartile of foresight, those with second (odds ratio, OR = 0.68, 95% CI = 0.62 ~ 0.75), third (OR = 0.50, 95% CI = 0.45 ~ 0.56) and fourth quartile (OR = 0.42, 95% CI = 0.37 ~ 0.48) of foresight had lower odds ratio of poor SRH. Similarly, older adults with the second (OR = 1.11, 95% CI = 1.01 ~ 1.23) and fourth (OR = 0.79, 95% CI = 0.69 ~ 0.90) quartile of self-adjustment also had lower OR of poor SRH than those with lowest quartile of self-adjustment. These findings show that EGA outperforms the traditional methods, which may be helpful to understand resilience deeply. CD-RISC should be interpreted into two aspects among community-dwelling older adults in China, highlighting the significance of the practical value and cultural context of resilience.
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Affiliation(s)
- Yujie Wang
- School of Public Health, Fudan University, Shanghai, China
| | - Jixiang Xu
- School of Public Health, Fudan University, Shanghai, China
| | - Shitong Yang
- School of Public Health, Fudan University, Shanghai, China
| | - Junjia Jiang
- School of Public Health, Fudan University, Shanghai, China
| | - Junling Gao
- School of Public Health, Fudan University, Shanghai, China.
- Collaborative Innovation Cooperative Unit of National Clinical Research Center for Geriatric Diseases, Shanghai, China.
- Core Unit of Shanghai Clinical Research Center for Geriatric Diseases, Shanghai, China.
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Akosile CO, Onyekwuluje C, Mgbeojedo UG, Okoye EC, Fabunmi AA, Mong EU, Okafor AC. Social Support, Social Participation, and Life Accomplishment of Older Adult Residents of Assisted Living Facilities and Their Adjoining Communities. Gerontol Geriatr Med 2023; 9:23337214231218797. [PMID: 38146455 PMCID: PMC10749526 DOI: 10.1177/23337214231218797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 11/11/2023] [Accepted: 11/20/2023] [Indexed: 12/27/2023] Open
Abstract
Objectives: To assess and compare levels of social support (SS), social participation (SP) and life accomplishment (LA) among older adults in some assisted-living facilities (ALFs) and their community-dwelling (CD) peers. Methods: One hundred twenty older adults (54 ALF, 66 CD) from a Nigerian population participated in this cross-sectional survey. The Multidimensional Scale for Perceived Social Support, the Participation Scale and the Life Habit Questionnaires were used to evaluate levels of SS, SP, and LA, respectively. Data was analyzed using descriptive statistics, Mann-Whitney U test and Spearman rank order correlation, at .05 alpha level. Results: Participation restriction (PR) was significantly more prevalent among the ALF group compared to the CD group (χ2 = 12.74; p = .01) but the two groups enjoyed comparable level of SS. LA was significantly better for the CD group in the overall score. LA had significant correlation with PR in both the ALFs (r = -.44; p < .05) and CD (r = -.62; p < .05) group. Conclusions: Older adults in ALFs received moderate SS, had LA, and a high PR, while CD older adults received a high SS and LA but had no PR. The findings implicate that social participation and enhancing community support for older adults may be important for a sustainable community.
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Yan T, Chan CWH, Chow KM, Li M. Experiences and perception of character strengths among patients with breast cancer in China: a qualitative study. BMJ Open 2022; 12:e061994. [PMID: 36307158 PMCID: PMC9621164 DOI: 10.1136/bmjopen-2022-061994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 10/06/2022] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To explore the patients' experiences on character strengths that Chinese patients experience after the diagnosis of breast cancer. DESIGN A qualitative, exploratory study using semistructured interviews based on the patients' lived experience after being diagnosed with breast cancer. Ethics approval was granted. Interviews were audiorecorded and transcribed verbatim. Values in Action Classification of Strengths provided conceptual framework for analysing strengths. Directed content analysis based on the classification of strengths and framework analysis were used to analyse transcribed data. The Standards for Reporting Qualitative Research guideline was followed. SETTING The Second Affiliated Hospital of Zhengzhou University and Henan Provincial Cancer Hospital in China. PARTICIPANTS Adult patients over 18 years, diagnosed with breast cancer between October 2019 and December 2020 were recruited. We used purposive sample method to collected data from 24 participants diagnosed with breast cancer. RESULTS Six themes (virtues) emerged from our analysis. In addition, two new subthemes (character strengths) emerged in this study, selflessness and pragmatism, respectively. Patients with breast cancer described a large repertoire of character strengths they used or wished for during survivorship, including gratitude, hope, humility, kindness, humour, honesty and forgiveness. Cultural values (eg, collectivism, familyism, Confucianism and Buddhist beliefs) helped structure the experiences of Chinese patients' character strengths. Patients wanted their character strengths to be more noticed, appreciated and encouraged by others and reported their psychological trajectory of using personal strengths. CONCLUSION The findings indicated that patients with breast cancer believing character strengths are important to them. Medical staff should pay more attention to motivating and cultivating character strengths of patients with breast cancer. Attention to make strength-based practices workable in clinical health promotion programmes is necessary. The healthcare system should develop tailored individualised psychological services that specifically address patients' needs for the application of personalised character strengths. TRIAL REGISTRATION NUMBER NCT04219267, Pre-results.
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Affiliation(s)
- Tingting Yan
- School of Nursing, Peking University, Beijing, Beijing, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ka Ming Chow
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, Beijing, China
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Sharma S, Bluck S. Older adults recall memories of life challenges: the role of sense of purpose in the life story. CURRENT PSYCHOLOGY 2022; 42:1-16. [PMID: 35874962 PMCID: PMC9294762 DOI: 10.1007/s12144-022-03439-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/12/2022]
Abstract
Late life is still often characterized as a time of loss and decline. The current study moved beyond this view, using both the resilience framework and the life story approach to highlight the rich life experiences of older adults. Doing so created an opportunity to explore perspectives on sense of purpose in life, from the vantage point of old age. The study had two central questions. That is, how have older adults drawn on their sense of purpose across their lives, and what factors led to the development of a sense of purpose? Following guidelines for the consensual qualitative research method (CQR; Hill et al., The Counseling Psychologist, 25(4), 517-572, 1997; Hill & Knox, 2021), in-depth, semi-structured interviews were conducted with 18 older women and men (aged 60 - 100 years) and transcribed for analysis. The CQR method revealed seven domains in the interviews. Three domains were relevant to the first research question, including: overcoming life challenges to pursue purpose, perspective-taking to maintain purpose, and purpose as part of one's religion. Four domains provided insights on the second research question: life background influencing purpose, shifts in purpose across life, fulfilling purpose across life, and obstacles to pursuing purpose in life. Findings highlighted how older people use sense of purpose as a guide in the face of life's inevitable challenges. They also revealed the unique life story paths that lead to the development of purpose across individuals' lifetimes. The implications of maintaining a sense of purpose in life, across the later years, are discussed.
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Affiliation(s)
- Shubam Sharma
- Department of Psychological Sciences, Kennesaw State University, Kennesaw, GA USA
| | - Susan Bluck
- Department of Psychology, University of Florida, Gainesville, FL USA
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Wister A, Klasa K, Linkov I. A Unified Model of Resilience and Aging: Applications to COVID-19. Front Public Health 2022; 10:865459. [PMID: 35685765 PMCID: PMC9170899 DOI: 10.3389/fpubh.2022.865459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/21/2022] [Indexed: 11/18/2022] Open
Abstract
Drawing on multidisciplinary research focusing on a spectrum ranging from individual experience to structural system-level risk response and resilience, this article develops a rationale for a Unified Model of Resilience and Aging (UMRA). In response to a broad range of adversities associated with aging, it details the ways in which some individuals are able to bounce back better than others, or adapt better than expected, termed resilience. However, resilience and aging theoretical models have developed out of different disciplinary developments, ranging from individual levels to structural level complex systems, including several gerontological theoretical models addressing adaptation to life course and aging processes. The article reviews and synthesizes prior conceptual and theoretical work, and their empirical groundings, in order to develop an integrated resilience model with wide applications to aging-related problems including chronic illness, mental health, widowhood, poverty, caregiving burden, etc. The article focuses specifically on COVID-19 pandemic risk, response and resilience in order to specify applications of the UMRA, and to suggest avenues for future research and testing of theoretical axioms.
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Affiliation(s)
- Andrew Wister
- Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada
- *Correspondence: Andrew Wister ; orcid.org/0000-0002-0045-7428
| | - Katarzyna Klasa
- University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Igor Linkov
- United States Army Corps of Engineers, Engineering Research and Development Center, Vicksburg, MS, United States
- Carnegie Mellon University, Pittsburg, PA, United States
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Bajpai N, Kulshreshtha K, Dubey P, Sharma G. Travesty of Life Elders Abuse an Inquiry of Physical and Psychological Abuse. AGEING INTERNATIONAL 2022; 48:413-437. [PMID: 35068623 PMCID: PMC8760600 DOI: 10.1007/s12126-021-09479-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 11/29/2022]
Abstract
Elder abuse is evil in human society. The present paper unveils this social issue from two major factors psychological and physical abuse. The study sensitizes the subject matter of study by examining the effects of demographic variables like gender and age on elders. For achieving the purpose of the study the research is a design by exploring and validating the factors of measuring elder abuse through the mix method approach, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). To test the established hypotheses of the effects of the demographic variable on elders the two-way ANOVA was applied. The present study verdicts the development of a sound measurement scale with two influence factors. The separate and composite effect of aging and gender type on elder abuse was evidenced. These findings are crucial especially when the prevalence of elder abuse is higher during COVID-19. The limited novel understudied variable opens an avenue for further research in behavioral and demographic variables like marital status. The present study has practical insinuation for caring the elders in any human society like physical and psychological treatment of elders to avoid abusive situations. In addition, the study attempts to validate the novel issues like psychological and physical abuse of elders in the dimensions of demographic variables. Some rare studies in the Indian continent established the motivation of conducting the research on this dimension.
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Affiliation(s)
- Naval Bajpai
- ABV-Indian Institute of Information Technology and Management (ABV-IIITM), Gwalior, MP India
| | | | - Prince Dubey
- Institute of Business Management, GLA University, Mathura-281406 (U.P), India
| | - Gunjan Sharma
- Institute of Business Management, GLA University, Mathura-281406 (U.P), India
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Fang L, Dong M, Fang W, Zheng J. Relationships between care burden, resilience, and depressive symptoms among the main family caregivers of stroke patients: A cross-sectional study. Front Psychiatry 2022; 13:960830. [PMID: 36203823 PMCID: PMC9530984 DOI: 10.3389/fpsyt.2022.960830] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study aims to explore the potential mediating role of resilience between care burden and depressive symptoms in family caregivers of stroke patients. METHODS A cross-sectional study was conducted with a convenience sample involving 245 main family caregivers of stroke patients recruited from the neurology department of a Tertiary A hospital in China. Mediation analyses were conducted using the PROCESS macro (Model 4) for SPSS, applying the Bootstrap analysis with 5,000 samples and a 95% confidence interval. RESULTS The results showed that with constant hemiplegia side, Barthel Index, education level, monthly income, care time per day, and living with patients in regression equations, the resilience partially mediated the correlation of care burden and depressive symptoms with a mediation effect ratio of 26.32%. CONCLUSIONS Resilience plays a mediating role in the correlation between care burden and depressive symptoms. IMPACT The findings indicated a protective effect of resilience in alleviating the negative influences of care burden on depressive symptoms, suggesting that resilience-training intervention may be developed to mitigate depressive symptoms of the main family caregivers of stroke patients.
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Affiliation(s)
- Linlin Fang
- Department of Nursing, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Mengyuan Dong
- School of Nursing and Rehabilitation, Shandong University, Jinan, China
| | - Wenbo Fang
- School of Civil and Hydraulic Engineering, Tibet Agriculture and Animal Husbandry University, Linzhi, China
| | - Jin Zheng
- Department of Nursing, The First Affiliated Hospital of China Medical University, Shenyang, China
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Beeris C, Niemeijer A, Machielse A. Count Your Life by Smiles and Tears: An Integrative Review on Resilience and Growing Older. Gerontol Geriatr Med 2022; 8:23337214221119050. [PMID: 36090316 PMCID: PMC9449508 DOI: 10.1177/23337214221119050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/15/2022] [Accepted: 07/25/2022] [Indexed: 11/15/2022] Open
Abstract
The concept of “resilience” is considered helpful in understanding how people
navigate adversities typical to later life. It is also a concept of growing
interest internationally in research and in social policy and (social) practice.
This article employs an integrative review methodology to explore current trends
in theoretical and empirical research on resilience. A total of 25 quantitative
and qualitative studies from 2011 to 2020 are included in this review. Findings
indicate how the reviewed studies typically define resilience from three
perspectives: resource-based, outcome-based, and process-based perspectives of
resilience. In the results of the same studies, the resource-based and
outcome-based perspectives are elaborated upon while detailed results from a
process-based perspective are lacking. Additionally, even though adversity is
recognized as a key element in conceptualizing resilience, it is scarcely
defined if defined at all in the reviewed studies. Further research is
recommended in this article to contribute to a realistic and encouraging
narrative on growing older in social policy and (social) practice.
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Affiliation(s)
- Chloe Beeris
- University of Humanistic Studies, Utrecht, The Netherlands
| | | | - Anja Machielse
- University of Humanistic Studies, Utrecht, The Netherlands
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Moderating effect of psychological resilience on the perceived social support and loneliness in the left-behind elderly in rural areas†. FRONTIERS OF NURSING 2021. [DOI: 10.2478/fon-2021-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
To investigate the loneliness and psychological resilience with the perceived social support of the left-behind elderly in rural areas and explore the moderating effect of psychological resilience on the understanding of social support and loneliness of the left-behind elderly in rural areas.
Methods
A cross-sectional study was conducted; 272 left-behind elderly people in 6 rural villages in the Sichuan Province were investigated by using the General Situation Questionnaire, Perceived Social Support Scale (PSSS), Connor-Davidson Resilience Scale (CD-RISC), and the University of California at Los Angeles Loneliness Scale (UCLA) with a stratified random cluster sampling method.
Results
The loneliness score of the left-behind elderly in rural areas was 52.54 ± 7.25, the psychological resilience score was 78 (68.87), and the perceived social support score was 57 (51.62). The perceived social support and psychological resilience were negatively correlated with loneliness, while the perceived social support was positively correlated with psychological resilience. The moderating effect of psychological resilience on the perceived social support and loneliness of the left-behind elderly in rural areas was −0.102 (P < 0.001).
Conclusions
Higher level resilience is of positive significance to alleviate the negative effect of social support on loneliness. Improving the resilience of the left-behind elderly in rural areas is a beneficial exploration to promote their mental health.
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Enhancing psychological resilience at the cusp of older ages: the role of social networks. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x2100180x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Prior research has established a positive association between social support and psychological resilience. In this study, we seek to examine whether and to what extent aspects of individuals’ social network – specifically size (how many relatives and friends one has) and strength (how often did one communicate with close network members and at the time of important decisions) – are related to greater psychological resilience. We use data pertaining to 1,609 respondents from the Panel on Ageing and Transitions in Health Survey (PATHS), 2016–2017, a national study of 1,654 older midlife adults, aged 50–59, in Singapore. We estimate the relationship between social networks and psychological resilience, using inverse probability weighted regression adjustment to account for the possibility of a selection bias whereby individuals with larger or stronger social networks may be more resilient at the outset. We find that strong social networks are associated with greater psychological resilience among older midlife adults, regardless of the size of the network. Having a large social network is associated with greater resilience only if it is also a strong network. Maintaining stronger, even if small, social networks may enable individuals at the cusp of older ages to be better prepared to deal with stressful life events and challenges associated with older midlife.
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Numans W, Regenmortel TV, Schalk R, Boog J. Vulnerable persons in society: an insider's perspective. Int J Qual Stud Health Well-being 2021; 16:1863598. [PMID: 33357080 PMCID: PMC7782249 DOI: 10.1080/17482631.2020.1863598] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 12/09/2020] [Accepted: 12/09/2020] [Indexed: 10/25/2022] Open
Abstract
Purpose: Self-reliance and social participation are strongly promoted by social policy. Both concepts are linked to the concept of vulnerability, for people who do not meet these standards are labelled "vulnerable people". In this paper, the insider's perspective takes central stage by seeking to explore what it means to be labelled a "vulnerable person", and through this to further our insight into the meaning of the concept of vulnerability. Method: Thirty-three in-depth interviews were conducted with 16 allegedly vulnerable people. The data were subjected to thematic content analysis. Results: Our analysis revealed three main dimensions and eight sub-dimensions of perceived vulnerability, outlining an insider's concept of vulnerability. This concept includes manifestations of vulnerability, feelings coexisting with vulnerability, and the image of vulnerable people. Conclusion: The perception of vulnerability changes when interacting with others in society, especially with social policy implementers. In this interaction, the perceived vulnerability increases and becomes societal vulnerability. It concerns a dependency situation in which one's strength and self-determination are not recognized, and the help needed is not provided. By acknowledging the insider's perspective, social policy can fulfil a more empowering role towards "vulnerable people" and contribute to people's well-being.
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Affiliation(s)
- Wilma Numans
- CONTACT Wilma Numans Tranzo, Scientific Center for Care and Welfare/Academic Collaborative Center Social Work - Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg5000 LE, The Netherlands
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16
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Zhang D, Wang R, Zhao X, Zhang J, Jia J, Su Y, Wang K. Role of resilience and social support in the relationship between loneliness and suicidal ideation among Chinese nursing home residents. Aging Ment Health 2021; 25:1262-1272. [PMID: 32602736 DOI: 10.1080/13607863.2020.1786798] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Loneliness is a risk factor of suicidal ideation, while resilience and social support are protective factors; however, the complex mechanisms behind these factors have not been examined among nursing home residents. This study evaluated the mediating effect of resilience on the association between loneliness and suicidal ideation and whether this mediating effect was moderated by social support. METHODS Residents (N = 538; Aged ≥60years; 321 female, 217 male) from 37 nursing homes in China completed this cross-sectional study. Their loneliness, resilience, social support, and suicidal ideation were measured. Regression analyses using bootstrapping methods were conducted to explore the mediating and moderating effects. RESULTS Some residents (14.9%, 80/538) reported current suicidal ideation. The correlation between loneliness and suicidal ideation was partially mediated by resilience (indirect effect = 0.067, 95% CI = 0.011-0.122). Overall social support moderated the resilience on suicidal ideation, indirectly impacting loneliness on suicidal ideation (moderating effect = 0.086 [95% CI = 0.005-0.167]). Support from family and nursing home staff moderated the direct (path c') and indirect path (path b) of the mediation model, respectively. CONCLUSIONS Our findings underscore the vital role of resilience and social support to buffer against suicidal ideation, which is common among nursing home residents in China.HighlightsWe evaluated suicidal ideation in mainland Chinese nursing home residentsLoneliness and suicidal ideation were partially mediated by resilienceSocial support moderated the effect of loneliness and resilience on suicidal ideationThe results were self-reported and are not generalizable to all of ChinaResilience and social support can buffer against suicidal ideation among residents.
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Affiliation(s)
- Dan Zhang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Rui Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Xia Zhao
- Department of Health Management, Heze Medical College, Heze, Shandong, China
| | - Jie Zhang
- China Department of Sociology, State University of New York Buffalo State, Buffalo, NY, USA.,School of Public Health, Shandong University, Jinan, Shandong, China
| | - Jihui Jia
- School of Nursing, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing, Shandong University, Jinan, Shandong, China.,School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Kefang Wang
- School of Nursing, Shandong University, Jinan, Shandong, China
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17
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Kamalpour M, Rezaei Aghdam A, Watson J, Tariq A, Buys L, Eden R, Rehan S. Online health communities, contributions to caregivers and resilience of older adults. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:328-343. [PMID: 33278312 DOI: 10.1111/hsc.13247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 10/06/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
The aim of this paper is twofold. Firstly, to investigate the potential benefits of online health communities (OHCs) for informal caregivers by conducting a systematic literature review. Secondly, to identify the relationship between the potential benefits of OHCs and resilience factors of older adults. Performing a thematic analysis, we identified the potential benefits of OHCs for informal caregivers of older adults, including two salient themes: (a) caregivers sharing and receiving social support and (b) self and moral empowerment of caregivers. Then, we uncovered how these potential benefits can support resilience of older adults. Our findings show that sharing and receiving of social support by informal caregivers, and self and moral empowerment of informal caregivers in OHCs, can support four resilience factors among older adults, including self-care, independence, altruism and external connections. This review enables a better understanding of OHCs and Gerontology, and our outcomes also challenge the way healthcare and aged-care service providers view caregivers and older adults. Furthermore, the identified gap and opportunities would provide avenues for further research in OHCs.
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Affiliation(s)
| | | | - Jason Watson
- Queensland University of Technology, Brisbane, Australia
| | - Amina Tariq
- Queensland University of Technology, Brisbane, Australia
| | - Laurie Buys
- University of Queensland, Brisbane, Australia
| | - Rebekah Eden
- Queensland University of Technology, Brisbane, Australia
| | - Syed Rehan
- Queensland University of Technology, Brisbane, Australia
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18
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Morse JM, Kent-Marvick J, Barry LA, Harvey J, Okang EN, Rudd EA, Wang CY, Williams MR. Developing the Resilience Framework for Nursing and Healthcare. Glob Qual Nurs Res 2021; 8:23333936211005475. [PMID: 33869667 PMCID: PMC8020405 DOI: 10.1177/23333936211005475] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 12/11/2022] Open
Abstract
Despite four decades of resilience research, resilience remains a poor fit for practice as a scientific construct. Using the literature, we explored the concepts attributed to the development of resilience, identifying those that mitigate symptoms of distress caused by adversity and facilitate coping in seven classes of illness: transplants, cancer, mental illness, episodic illness, chronic and painful illness, unexpected events, and illness within a dyadic relationship. We identified protective, compensatory, and challenge-related coping-concept strategies that healthcare workers and patients use during the adversity experience. Healthcare-worker assessment and selection of appropriate coping concepts enable the individual to control their distress, resulting in attainment of equanimity and the state of resilience, permitting the resilient individual to work toward recovery, recalibration, and readjustment. We inductively developed and linked these conceptual components into a dynamic framework, The Resilience Framework for Nursing and Healthcare, making it widely applicable for healthcare across a variety of patients.
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Affiliation(s)
- Janice M. Morse
- University of Utah, Salt Lake City, USA
- University of Alberta
| | | | - Lisa A. Barry
- University of Utah, Salt Lake City, USA
- Intermountain Healthcare, Primary Children’s Hospital, Salt Lake City, UT, USA
| | - Jennifer Harvey
- University of Utah, Salt Lake City, USA
- Alaska Native Medical Center, Anchorage, Alaska
| | | | | | | | - Marcia R. Williams
- University of Utah, Salt Lake City, USA
- Cedarville University, Ohio
- Kettering Health Network, Cedarville, Ohio
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19
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Aarts E, Fleuren H, Sitskoorn M, Wilthagen T. Involve Residents to Ensure Person-Centered Nursing Home Care During Crises Like the COVID-19 Outbreak. THE NEW COMMON 2021. [PMCID: PMC7978698 DOI: 10.1007/978-3-030-65355-2_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Nursing homes aim to provide person-centered care and recognize residents as unique individuals with their own histories, life goals, and preferences. The life expectancy of nursing home residents is rather limited. Nursing homes have been hit hard by COVID-19 because of an increased risk of death and a total nursing home lockdown from March 19 until the end of May 2020. Although social relationships are a basic human need and the fulfillment of social needs is essential for both physical and mental health, nursing home residents were no longer allowed to meet their loved ones. This decision was taken without involving residents and their loved ones and without considering the psychosocial impact of such measures for residents and their loved ones. When visitors were again allowed in the nursing homes, this was valued highly. To enable decent decision-making, we call both the government and nursing homes to involve residents and their families in decision-making. It is essential to know how residents weigh the risk of a COVID-19 infection and the possible implication of them opposing social isolation. We have to adapt to a new common and need to stop talking about residents and their loved ones and start talking with them.
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Affiliation(s)
- Emile Aarts
- Tilburg University, Tilburg, The Netherlands
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20
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Casey D, Gallagher N, Devane D, Woods B, Murphy K, Smyth S, Newell J, Murphy AW, Clarke C, Foley T, Timmons F, Dröes RM, O’Halloran M, Windle G, Irving Lupton K, Domegan C, O’Shea E, Dolan P, Doyle P. The feasibility of a Comprehensive Resilience-building psychosocial Intervention (CREST) for people with dementia in the community: protocol for a non-randomised feasibility study. Pilot Feasibility Stud 2020; 6:177. [PMID: 33292667 PMCID: PMC7667740 DOI: 10.1186/s40814-020-00701-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 10/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A dementia diagnosis can prevent people from participating in society, leading to a further decline in cognitive, social and physical health. However, it may be possible for people with dementia to continue to live meaningful lives and continue to participate actively in society if a supportive psychosocial environment exists. Resilience theory, which focuses on strengthening personal attributes and external assets in the face of serious challenges, may provide a scaffold on which an inclusive multifaceted psychosocial supportive environment can be built. This protocol paper describes a study to determine the feasibility of conducting a multifaceted complex resilience building psychosocial intervention for people with dementia and their caregivers living in the community. METHODS This is a non-randomised feasibility study. Ten participants with dementia and their primary caregivers living in the community will be recruited and receive the CREST intervention. The intervention provides (a) a 7-week cognitive stimulation programme followed by an 8-week physical exercise programme for people with dementia and (b) a 6-week educational programme for caregivers. Members of the wider community will be invited to a dementia awareness programme and GP practices to a dementia training workshop. Trained professionals will deliver all intervention components. Outcomes will assess the feasibility and acceptability of all study processes. The feasibility and acceptability of a range of outcomes to be collected in a future definitive trial, including economic measurements, will also be explored. Finally, social marketing will be used to map a route toward stigma change in dementia for use in a subsequent trial. Quantitative feasibility outcome assessments will be completed at baseline and after completion of the 15-week intervention while qualitative data will be collected at recruitment, baseline, during and post-intervention delivery. CONCLUSION This feasibility study will provide evidence regarding the feasibility and acceptability of a comprehensive multifaceted psychosocial intervention programme for people with dementia and their caregivers (CREST). The results will be used to inform the development and implementation of a subsequent RCT, should the findings support feasibility. TRIAL REGISTRATION ISRCTN25294519 Retrospectively registered 07.10.2019.
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Affiliation(s)
- Dympna Casey
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
| | - Niamh Gallagher
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
| | - Declan Devane
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
| | - Bob Woods
- Dementia Services Development Centre, Bangor University, Bangor, Wales
| | - Kathy Murphy
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
| | - Siobhán Smyth
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
| | - John Newell
- School of Mathematics, Statistics & Applied Mathematics, National University of Ireland Galway, Galway, Ireland
| | - Andrew W. Murphy
- Department of General Practice, School of Medicine, National University of Ireland Galway, Galway, Ireland
| | | | - Tony Foley
- Department of General Practice, University College Cork, Cork, Ireland
| | - Fergus Timmons
- The Alzheimer Society of Ireland, Temple Road, Blackrock, Co. Dublin Ireland
| | - Rose-Marie Dröes
- Department of Psychiatry, VU University Medical Center, A.J. Ernststraat 1187 (kamer D0.03), Amsterdam, The Netherlands
| | - Martin O’Halloran
- College of Engineering & Informatics, National University of Ireland Galway, Galway, Ireland
| | - Gill Windle
- School of Health Sciences, Bangor University, Bangor, Wales
| | - Kate Irving Lupton
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Christine Domegan
- J.E. Cairnes School of Business & Economics, National University of Ireland Galway, Galway, Ireland
| | - Eamon O’Shea
- Centre for Economic & Social Research on Dementia, ILAS Building, National University of Ireland, Galway, Ireland
| | - Pat Dolan
- UNESCO Child and Family Research Centre, School of Political Science and Sociology, National University of Ireland, Galway, Ireland
| | - Priscilla Doyle
- School of Nursing & Midwifery, National University of Ireland Galway, Aras Moyola, Galway, Ireland
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21
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Angevaare MJ, Roberts J, van Hout HPJ, Joling KJ, Smalbrugge M, Schoonmade LJ, Windle G, Hertogh CMPM. Resilience in older persons: A systematic review of the conceptual literature. Ageing Res Rev 2020; 63:101144. [PMID: 32835890 DOI: 10.1016/j.arr.2020.101144] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/26/2020] [Accepted: 08/10/2020] [Indexed: 12/01/2022]
Abstract
Although ageing research increasingly incorporates resilience, a common notion on what resilience means is lacking. We aimed to give a comprehensive overview of the conceptual literature on resilience in older persons, identifying areas of consensus and variation/debate. A systematic search of eight databases from different disciplines led to the inclusion of 36 texts. Across the conceptual literature of resilience in older persons, three common features of descriptions of resilience were identified: a stressor, a response and a mechanism. Based on differences in their interpretation of how resilience is expressed we distinguished two perspectives. The first, classical and most widely applied perspective, describes the expression of resilience as a positive response to a high intensity stressor. The second, newer perspective, describes resilience in the context of responses relative to equilibrium, following low intensity stressors. Almost all descriptions across the two perspectives describe the resilience mechanism to be dynamic and emphasize the importance of the context in achieving resilience. This review provides clarity on the current conceptual status of resilience in older persons, an important step towards a higher level of consistency in the future use of resilience in ageing.
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Affiliation(s)
- M J Angevaare
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands.
| | - J Roberts
- Dementia Services Development Centre, School of Health Sciences, Bangor University, Ardudwy, Holyhead Road, Bangor, LL56 2PX, Gwynedd, UK
| | - H P J van Hout
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands
| | - K J Joling
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of General Practice, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands
| | - M Smalbrugge
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands
| | - L J Schoonmade
- Medical Library, Vrije Universiteit Amsterdam, De Boelelaan 1117, P.O. Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - G Windle
- Dementia Services Development Centre, School of Health Sciences, Bangor University, Ardudwy, Holyhead Road, Bangor, LL56 2PX, Gwynedd, UK
| | - C M P M Hertogh
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Medicine for Older People, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, Amsterdam, the Netherlands
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22
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Yang H, Hagedorn A, Zhu H, Chen H. Mental health and well-being in older women in China: implications from the Andersen model. BMC Geriatr 2020; 20:254. [PMID: 32711464 PMCID: PMC7382081 DOI: 10.1186/s12877-020-01639-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health and well-being among older women is an important topic due to the feminization of later life as women tend to have longer life expectancy resulting in elderly women being more advanced in age and outnumbering men. Older women generally play a key role in their families lifelong and mostly depend on social support from their family and close friends in older age to cope with any limitations they face as a result of age-related changes in their health and functional ability. METHODS We examine which factors predict mental health and well-being in older women using the Third Wave of the 2010 Female Social Status Survey conducted by the All-China Women's Federation (n = 3527). Applying the Andersen Model, regression analysis exploring predisposing, enabling and health need variables were tested using SPSS version 22 predicting a mental health scale. RESULTS Results showed that living with a spouse was not a significant predictor of mental health for women, while it was for men (b = - 1.2, p < .01), ownership of property is significant only for men (b = -.96, p < .05), whereas women's mental health is more strongly predicted by current exercise (b = -.89, p < .01) and participation in leisure activities (b = -.69, p < .001). Close relationships with neighbors, qualifying for old-age benefit programs and being in better overall health supports positive mental health for both men and women. Reporting delayed medical treatment is associated with a negative impact on mental health for men, but oddly women who report the same actually report better mental health, perhaps suggesting older women take pride in their self-sacrifice. CONCLUSION The findings of this study suggest that gender differences in wealth, living alone, and social participation are interpreted differently by women, who have longer lives with generally fewer material resources. Enabling factors tend to be more associated with financial factors for men, while women rely on a social convoy to thrive longer than their male counterparts.
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Affiliation(s)
- Hui Yang
- Department of Sociology, Minzu University of China, Beijing, China
| | - Aaron Hagedorn
- University of Texas at Arlington School of Social Work, Arlington, TX, 76019, USA
| | - He Zhu
- Faculty of Humanities and Social Sciences, Bejing University of Technology, Beijing, China
| | - Honglin Chen
- Department of Social Work, School of Social Development and Public Policy, Fudan University, 220 Handan Road, Shanghai, 200433, China.
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Abstract
Background and objectives: We explore the internal and external resources that older adults use to negotiate adversity and related to later life. We investigated the experiences older adults had with adversity and explored the factors that promote and protect resilience and the how these factors shaped the process of managing adversity related to aging.Research design and methods: Semi-structured interviews were conducted with 64 resilient adults ranging in age from 53 to 94 years of age, with an average of 71. Participants were defined as resilient on the basis of their willingness to identify as such. Grounded Theory coding techniques were applied to identify themes reflecting distinct ways in which participants dealt with what they indicated were the most significant hardships and adversities in their lives.Results: What emerged from the narratives about resilience and adversity were accounts of expressions of resilience that reflected the importance in having a resilient identity. Three major themes reflecting psychological and behavioral factors were derived from the data: 1. having vital components of resilience, or behaviors and beliefs in place, that encompass resilience as a way of being; 2. a broad but articulate set of strategies that participants actively engaged with to manage adversity, and 3. a set of protective practices used to prevent risk and prevail in the face of hardship.Discussion and implications: Findings suggest that dealing with adversity in later life requires the use of substantial internal and external resources in what can characterized as a proactive fashion. The results are presented as an interpretation of the participants' perceptions of their resilience and the role it plays in self-concept, strategic planning, and proactive practices. Implications for helping to put resilience into everyday practice are considered.
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Affiliation(s)
- Lydia K. Manning
- College of Graduate Studies and the Division of Human Services at Concordia University-Chicago
| | - Lauren Bouchard
- Concordia University-Chicago in Leadership and Gerontology. Concordia University-Chicago, 7400 Augusta Street, River Forest, IL 60305
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Waterworth S, Raphael D, Gott M, Arroll B, Jarden A. Uncovering strengths within community dwelling older adults: What does it mean for health care practice? HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:932-940. [PMID: 31840318 DOI: 10.1111/hsc.12924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 11/10/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
The aim of this paper is to present the psychological strengths we identified from interviews with community dwelling older adults. Data for this paper is drawn from participants in a community dwelling older adult study. The latter involved qualitative in-depth interviews with the participants exploring their well-being. All participants were community dwelling and living in a region in the North Island of New Zealand. Interviews took place between March 2017 to September 2017. Thirty-seven older adults between the ages of 66-99 took part in semi-structured interviews and all interviews were audio-recorded. Interviews ranged from 1 to 3 hr. Analysis was informed by the Values in Action Character strengths framework. We were able to identify strengths within the VIA conceptual framework comprising; cognitive strengths, emotional strengths, social and community strengths, protective strengths and transcendental strengths. Throughout this study we found that participants experienced difficulties in identifying and talking about their strengths. In many ways this may reflect participants' strength of humility, demonstrating modesty in talking about themselves. This study has highlighted the challenges older adults experienced in identifying their own strengths. However, the study has demonstrated how narratives can be one way of uncovering psychological strengths with older adults. In particular, these findings highlight the range of strengths, for example, bravery, gratitude, hope, humour, kindness, perseverance, spirituality, that older adults have and give a voice in highlighting these. However, more practical ways of making strength-based practices workable in daily practice, for example, in clinical assessment and health promotion programs are required.
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Affiliation(s)
- Susan Waterworth
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Deborah Raphael
- School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Merryn Gott
- School of Nursing, The University of Auckland, Auckland, New Zealand
| | - Bruce Arroll
- School of Population Health, The University of Auckland, Auckland, New Zealand
| | - Aaron Jarden
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Vic, Australia
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25
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Hughes S, Burch S. 'I'm not just a number on a sheet, I'm a person': Domiciliary care, self and getting older. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:903-912. [PMID: 31833154 PMCID: PMC7187425 DOI: 10.1111/hsc.12921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 11/06/2019] [Accepted: 11/25/2019] [Indexed: 06/10/2023]
Abstract
Social care funding is reducing in spite of a growing older population. Within this context, domiciliary services are increasingly failing to deliver care that respects the individuality and heterogeneity of older people. To date, there has been limited research in the U.K. that explores, from the older person's perspective, how care practices interact with self. Using biographical-narrative methodology, this study takes a constructionist approach to understand the individual's lived experience of care and how it interacts with sense of self. A three-stage model of data collection was used, beginning with a narrative biographic enquiry, exploring with participants (65 yrs +, n = 17) their journeys into care and any possible relationship to personal identity. Stage 2 involved a two-week period of diary completion, with participants recording daily reflections on their care experiences. In stage 3, a semi-structured interview explored the diary entries, linking back to the narrative biographic enquiry to reveal ways in which specific care practices interacted with the sense of self. The findings reveal that a strong relationship between older person and formal carer, forged through familiarity, regularity and consistency, plays a significant role in promoting feelings of autonomy. Furthermore, such relationship mediates against the loss of executional autonomy that often accompanies increasing disability. Maintaining autonomy and control was a recurring theme, including in relation to home, privacy and dignity. Feelings of autonomy are also promoted when formal carers understand the unique ways in which individuals experience ageing and being in the cared-for relationship. This paper suggests that a care approach should be based on two tenets. First, a knowledge and insight into the importance of understanding and respecting the older person's continuing development of self, and second applying this knowledge to care through a positive, stable and consistent relationship between the older person and the carer.
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Affiliation(s)
- Suzanne Hughes
- Faculty of Health, Education Medicine and Social CareAnglia Ruskin UniversityCambridgeCambsUK
| | - Sarah Burch
- Faculty of Health, Education Medicine and Social CareAnglia Ruskin UniversityCambridgeCambsUK
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26
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Tariq A, Beihai T, Abbas N, Ali S, Yao W, Imran M. Role of Perceived Social Support on the Association between Physical Disability and Symptoms of Depression in Senior Citizens of Pakistan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1485. [PMID: 32106585 PMCID: PMC7084927 DOI: 10.3390/ijerph17051485] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 02/21/2020] [Accepted: 02/22/2020] [Indexed: 11/28/2022]
Abstract
An emerging body of literature has implied that perceived social support is known as an upstream element of cognitive health. Various dimensions of perceived social support may have divergent influence on physical and cognitive health in later life. The present study aimed to investigate the mediating role of perceived social support on the relationship between physical disability and symptoms of depression in senior citizens of Pakistan. The data were collected from three metropolitan cities (Lahore, Faisalabad, Multan) in the Punjab province of Pakistan and 100 participants were approached from each city with a total sample size of 300. The results demonstrated that family support, friends' support, and significant others' support mediated the association between physical disability and symptoms of depression, with an indirect effect of 0.024, 0.058, and 0.034, respectively. The total direct and indirect effect was 0.493. Physical disability was directly associated with symptoms of depression and greater physical disability predicted a higher level of symptoms of depression. Perceived social support, including family support, friends' support, and significant others' support, showed an indirect association with symptoms of depression. Furthermore, family support and friends' support were more significantly associated with symptoms of depression as compared to significant others' support. The research discoveries have better implications for health care professionals, hospice care workers, and policy makers. A holistic approach is required to prevent senior citizens from late-life mental disorders.
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Affiliation(s)
- Azam Tariq
- Department of Sociology, College of Humanities and Social Sciences, Huazhong Agricultural University, Wuhan 430070, China;
| | - Tian Beihai
- Department of Sociology, College of Humanities and Social Sciences, Huazhong Agricultural University, Wuhan 430070, China;
| | - Nadeem Abbas
- Institute of Social & Cultural Studies, University of the Punjab, Lahore 54000, Pakistan;
| | - Sajjad Ali
- College of Economics and Management, Huazhong Agricultural University, Wuhan 430070, China;
| | - Wang Yao
- Department of Social Security, College of Humanities and Social Sciences, Huazhong Agricultural University, Wuhan 430070, China;
| | - Muhammad Imran
- Department of Computer Science and Engineering, Shanghai Jiao Tong University, Shanghai 200240, China;
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Abstract
AbstractThe study of resilience in an older adult population is expanding rapidly. However, most theoretical models of resilience have been developed with children or young to middle-aged adults. The objective of the present study was to review systematically the qualitative literature examining resilience in older adults, and to develop a comprehensive model of resilience in older adulthood. A qualitative meta-synthesis was conducted to review the qualitative literature examining resilience from older adults’ perspectives. An exhaustive search of the literature revealed 1,752 articles. From these articles, 34 studies meeting inclusion criteria were selected for analysis. Across the 34 studies analysed, eight themes were revealed as important for achieving resilience later in life: perseverance and determination, self-efficacy and independence, purpose and meaning, positive perspective, social support, faith and prayer, previous experience and being proactive. These themes can be organised into a four-factor model: (a) Intrapersonal Protective Factors; (b) Interpersonal Protective Factors; (c) Spiritual Protective Factors; and (d) Experiential Protective Factors. This study presents a new model of resilience in older adulthood that is grounded in qualitative literature and is relevant and appropriate for an older adult population. This research may be useful for clinicians, support workers and researchers working with older individuals through improving our understanding of what contributes to resilience later in life.
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Zanatta F, Maffoni M, Giardini A. Resilience in palliative healthcare professionals: a systematic review. Support Care Cancer 2019; 28:971-978. [PMID: 31811483 PMCID: PMC7223999 DOI: 10.1007/s00520-019-05194-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 11/20/2019] [Indexed: 11/07/2022]
Abstract
Purpose Exposure to end-of-life and chronic illness on a daily basis may put palliative healthcare professionals’ well-being at risk. Resilience may represent a protective factor against stressful and demanding challenges. Therefore, the aim is to systematically review the quantitative studies on resilience in healthcare professionals providing palliative care to adult patients. Methods A literature search on PubMed, Scopus, Web of Science and PsycINFO databases was performed. The review process has followed the international PRISMA statement guidelines. Results At the initial search, a total of 381 records were identified. Twelve articles were assessed for eligibility and, finally, 6 studies met all the inclusion criteria. Of these, four researches were observational and two interventional pilot studies. From the systematic synthesis, palliative care providers’ resilience revealed to be related to other psychological constructs, including secondary traumatic stress, vicarious posttraumatic growth, death anxiety, burnout, compassion satisfaction, hope and perspective taking. Conclusions The current systematic review reported informative data leading to consider resilience as a process modulator and facilitator among palliative care professionals. A model on palliative healthcare providers’ experience and the role of resilience was proposed. Further studies may lead to its validation and implementation in assessment and intervention contributing to foster palliative healthcare professionals’ well-being.
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Affiliation(s)
- Francesco Zanatta
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marina Maffoni
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Anna Giardini
- Psychology Unit - Institute of Montescano, Istituti Clinici Scientifici Maugeri IRCCS, 27040, Montescano, PV, Italy.
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Critical reflections on the blind sides of frailty in later life. J Aging Stud 2019; 49:66-73. [PMID: 31229220 DOI: 10.1016/j.jaging.2019.100787] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 12/25/2022]
Abstract
Since the 1970's, frailty emerged as a major theme and has become one of the most researched topics in aging studies. However, throughout the years, the concept 'frailty' became susceptible to different interpretations and has been approached by different synonyms, which resulted in a confusing picture. Based on a narrative literature review, this theoretical paper not only attempts to describe these different views on frailty, but by criticizing the dominance of some of these views, it also aspires to move the research and policy agenda on frailty forward. This paper is part of the D-SCOPE project in Belgium, and critically reflects on the blind sides of the biomedical domination of frailty and discusses three main themes: 1) frailty as a multidimensional and multilevel concept; 2) positive perspectives on frailty in later life; and 3) the suggestion of moving from a merely deficit-based frailty approach towards the concept of frailty-balance. At the theoretical level, conceptualizing frailty is not simply an exercise in semantics, but altering the theoretical definition of frailty can have wide-ranging implications, not only for the way frailty prevalence is measured and handled, but also for public or personal opinions on frailty in older people, for care and support practices, and for the scope of legislation. Therefore, the final section of the paper presents three building blocks for future research and policy-making: 1) adopting a multidimensional, multilevel, dynamic and positive view on frailty; 2) moving from dependency to interdependency; and 3) giving voice to (the resilience of) frail older people.
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Resilience resources among African American women living with HIV in Southern United States. AIDS 2019; 33 Suppl 1:S35-S44. [PMID: 31397721 DOI: 10.1097/qad.0000000000002179] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES African American women living with HIV (WLH) often face various challenges to access to and benefit from healthcare across the HIV treatment cascade. Despite experiencing multiple forms of ongoing adversity, some African American WLH are able to adapt and stand strong. The current study aims to identify resources at various socioecological levels that facilitate resilience and explore how these resources interact with each other. DESIGN Guided by the theories of resilience, we collected qualitative data through in-depth interviews with 14 African American WLH in South Carolina, United States. METHODS Participants were purposely recruited and interviewed in private settings in 2016. With appropriate consent, each interview was recorded and was transcribed verbatim. Data analysis was conducted using NVivo 11.0. RESULTS The participants described six major resilience resources including first, internal strength; second, religion and spirituality; third, hopefulness about life and future; fourth, self-awareness and self-care; fifth, social support from family and community; and sixth, HIV-related health facilities. The themes that occurred in qualitative data also show how resilience resources at the family/community level and institutional level affected individual resources, and how these resources collaborated with each other. CONCLUSION The findings suggest that resilient African American WLH maintain hope in the face of adversity and seek out and obtain social support. Self-care, social support, and health facilities are particularly critical resources for African American WLH. Comprehensive interventions are needed to integrate these resources across multiple socioecological levels to enhance resilience and treatment outcomes in African American WLH.
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Isokääntä S, Koivula K, Honkalampi K, Kokki H. Resilience in children and their parents enduring pediatric medical traumatic stress. Paediatr Anaesth 2019; 29:218-225. [PMID: 30592109 DOI: 10.1111/pan.13573] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 12/05/2018] [Accepted: 12/24/2018] [Indexed: 01/25/2023]
Abstract
Due to the general lack of familiarity with the concept in the medical field, resilience is rarely considered in pediatric medical traumas. Resilience is an ability that enables recovery after adversities such as traumas, surgeries, serious health problems, or social issues. Stress from medical traumas encompasses both the psychological and physical responses of children and their families. Lack of resilience in children with medical traumatic stress may contribute to poor adjustment, slow recovery, disruptive behaviors, and psychiatric disorders. Furthermore, persistent parental distress increases the child's risk of low resilience. Consequently, these patients and their parents require early identification. This is achievable using a common stress measure such as the Perceived Stress Scale. Moreover, health care providers can screen patients' risks for low resilience, which include few social contacts, poor family functioning, and low cohesion among family members. Findings from the stress scale and screened risks could indicate the need for additional psychosocial support at the time of diagnosis of a serious illness, soon after injuries, and before and after operations. Such interventions can include decreasing distress, counseling children and their parents, and enabling strong connections to health care providers. Health care providers can help parents to minimize distress and adjust to their child's illness, thereby supporting the child's resilience, adjustment, and recovery.
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Affiliation(s)
- Siiri Isokääntä
- Department of Anaesthesia and Operative Services, Kuopio University Hospital, Kuopio, Finland.,Faculty of Health Sciences, Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
| | - Krista Koivula
- Department of Paediatrics, Kuopio University Hospital, Kuopio, Finland
| | - Kirsi Honkalampi
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland
| | - Hannu Kokki
- Faculty of Health Sciences, Department of Anaesthesiology and Intensive Care, School of Medicine, University of Eastern Finland, Kuopio, Finland
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Madsen W, Ambrens M, Ohl M. Enhancing Resilience in Community-Dwelling Older Adults: A Rapid Review of the Evidence and Implications for Public Health Practitioners. Front Public Health 2019; 7:14. [PMID: 30792974 PMCID: PMC6374312 DOI: 10.3389/fpubh.2019.00014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 01/17/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Resilience is a valuable platform for strengthening individuals and communities in the face of disaster. This review sought to evaluate the current literature related to individual and community resilience in community-dwelling older adults to understand the status of resilience in this population, identify gaps, and make recommendations about effective interventions that promote improved individual and community level capacity. Recognizing the concept of resilience is contested, the review conceptualized resilience as a collective concept that is multi-level and interdependent across those levels, cumulative, and contingent on context. Methods: The rapid review located 29 relevant peer review journal articles and industry reports related to research or evaluations of interventions aimed at increasing resilience at either a personal or community level. The results of these papers were thematically analyzed. Results: This review found personal resilience relates to those personal capacities and resources one has and uses to deal with individual stresses and change. We identified several recurring themes within those studies focused on personal resilience, including: (1) positive reframing and agency; (2) personal meaning and purpose; (3) acceptance and belonging. At a community level, we identified the following themes influence collective capacity and resources: (1) empowerment and shared decision making; (2) collective agency; and (3) collective leadership and engagement. Conclusions: The review highlighted the need to reframe how communities view older adults and shift the narrative away from focusing on age-related deficits toward acknowledging the economic and social contribution older adults make to the community through activities such as volunteering and the sharing of knowledge of history, culture and skills. Demonstrating the interdependence across levels, these activities illustrate personal-level capacities promoting collective action and participation as important for increasing community resilience. The review argues resilience is developed in everyday circumstances, therefore active involvement within communities needs to be encouraged within community-dwelling older adults. Developing active involvement will not only contribute to both personal and community level resilience but will enable communities to prosper and flourish through adversity.
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Affiliation(s)
- Wendy Madsen
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Meghan Ambrens
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
| | - Melanie Ohl
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD, Australia
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Low LPL. Decision-Making Experiences and Patterns in Residential Care Homes for Older Residents, Family Members and Care Providers. Gerontology 2018. [DOI: 10.5772/intechopen.74267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
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Wiles J, Miskelly P, Stewart O, Kerse N, Rolleston A, Gott M. Challenged but not threatened: Managing health in advanced age. Soc Sci Med 2018; 227:104-110. [PMID: 29941204 DOI: 10.1016/j.socscimed.2018.06.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 05/09/2018] [Accepted: 06/19/2018] [Indexed: 10/28/2022]
Abstract
In this paper we reflect on discussions with people of advanced age in Āotearoa New Zealand, and draw on theoretical frameworks of resilience and place in old age, to explore insights about the ways older people maintain quality of life and health. Twenty community-dwelling people of advanced age (85+) were recruited in 2015-16 from a large multidisciplinary longitudinal study of advanced age. These twenty participated in interviews about health in advanced age, impact of illnesses, interactions with clinicians, access to information, support for managing health, and perceptions of primary care, medications, and other forms of assistance. We use a positioning theory framework drawing on thematic and narrative analysis to understand the dynamic ways people in advanced age position themselves and the ways they age well through speech acts and storylines. People in advanced age saw themselves as challenged, rather than threatened, by adversities, and positioned themselves as able to draw on a lifetime of experience and resourcefulness and collaborations with supporters to deal with challenges. Key strategies include downplaying illness and resisting biomedical discourses of complexity, positioning embodied selves as having agency, and creative adaptation in the face of loss. People in advanced age exhibit resilience, maintaining wellbeing, autonomy and good physical and mental quality of life even while living with challenges such as functional decline and multi-morbidities. These findings have significance for supporters of older people, emphasising the need to move away from a narrow focus on problems to working together WITH people in advanced age to offer a more holistic approach that encourages and enhances adaptation and flexibility, rather than rigid and counterproductive coping patterns.
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Affiliation(s)
- Janine Wiles
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
| | - Philippa Miskelly
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
| | - Oneroa Stewart
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
| | - Ngaire Kerse
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
| | - Anna Rolleston
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
| | - Merryn Gott
- Faculty of Medical and Health Sciences, The University of Auckland, PO Box 92019, Auckland, 1071, New Zealand.
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Soares CC, Marques AM, Clarke P, Klein R, Koskinen L, Krasuckiene D, Lamsodiene E, Piscalkiene V, Küçükgüçlü Ö. Older people's views and expectations about the competences of health and social care professionals: a European qualitative study. Eur J Ageing 2018; 16:53-62. [PMID: 30886560 DOI: 10.1007/s10433-018-0466-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Adapting and providing quality services for people as they age is a common challenge across Europe. The perspective of older people is fundamental in a person-centred care approach. Expanding research at the European level that explicitly includes their views can offer a relevant contribution to the development of evidence-based guidelines that can be shared in education and training across health and social care professions. This study aimed to identify common meaningful dimensions of professional competence in health and social care emphasised by older people from six countries in different regions of Europe according to their experiences. A qualitative approach was chosen with a total of 95 semi-structured interviews conducted in Austria, Finland, Lithuania, Portugal, Turkey and UK, following a common topic guide. Participants in this study were aged 60 and above, and recruitment considered age, gender, level of education and living arrangements. Results identified a set of universal skills and practices that according to older people, health and social care professionals should meet. Competences at the interpersonal level were central in older people's discourses, and its core dimensions are anchored in relational, communication and socio-emotional skills of professionals. These findings reinforce the aspiration of establishing best practices in care that relies on the harmonisation of a competence framework that can be shared in the training and education of health and social care professionals across Europe and that voices older people's preferences, expectations and needs.
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Affiliation(s)
- Célia Casaca Soares
- 1Department of Social Sciences and Humanities, School of Health, Centre for Interdisciplinary Applied Research in Health, Instituto Politecnico de Setúbal, Campus do IPS, Estefanilha, Setúbal, 2910-761 Portugal.,2Centro de Investigação e Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Av. das Forças Armadas, Lisboa, 1649-026 Portugal
| | - António Manuel Marques
- 1Department of Social Sciences and Humanities, School of Health, Centre for Interdisciplinary Applied Research in Health, Instituto Politecnico de Setúbal, Campus do IPS, Estefanilha, Setúbal, 2910-761 Portugal.,2Centro de Investigação e Intervenção Social (CIS-IUL), Instituto Universitário de Lisboa (ISCTE-IUL), Av. das Forças Armadas, Lisboa, 1649-026 Portugal
| | - Pat Clarke
- 3School of Nursing and Allied Health, Liverpool John Moores University, Henry Cotton, 15/21 Webster St., Liverpool, L3 2ET UK
| | - Regina Klein
- 4Department Health + Social Care, Carinthia University of Applied Sciences, Hauptplatz 11, 9560 Feldkirchen, Austria
| | - Liisa Koskinen
- 5School of Health Care, Savonia University of Applied Sciences, PL 6 (Microkatu 1), 70201 Kuopio, Finland
| | - Daine Krasuckiene
- 6Faculty of Medicine, Kaunas University of Applied Sciences, Pramones pr. 20, 50468 Kaunas, Lithuania
| | - Evelina Lamsodiene
- 6Faculty of Medicine, Kaunas University of Applied Sciences, Pramones pr. 20, 50468 Kaunas, Lithuania
| | - Viktorija Piscalkiene
- 6Faculty of Medicine, Kaunas University of Applied Sciences, Pramones pr. 20, 50468 Kaunas, Lithuania
| | - Özlem Küçükgüçlü
- 7Department of Internal Medicine Nursing, Dokuz Eylul University, Inciralti İzmir, Turkey
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Association between social support and health-related quality of life among Chinese rural elders in nursing homes: the mediating role of resilience. Qual Life Res 2017; 27:783-792. [PMID: 29124499 DOI: 10.1007/s11136-017-1730-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2017] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aims to confirm the relationship between social support and health-related quality of life (HRQOL) among rural Chinese elders in nursing homes, and to examine the mediating role of resilience in the impact of social support on HRQOL. METHODS A cross-sectional survey of 205 elders aged 60 and above was conducted in five rural public nursing homes. Sociodemographic characteristics, the SF-36 questionnaire, and information about social support and resilience were collected. The researchers administered the questionnaires to the participants in a face-to-face setting. Descriptive analysis and a correlation matrix were used to indicate characteristics of the participants and bivariate correlations, respectively. The mediation analyses, composed of regression analysis and PROCESS analysis, were preformed to test both direct and indirect effects of social support on HRQOL, namely the mediating role of resilience. RESULTS Social support was positively related to HRQOL (β = 0.303, p < 0.001) among Chinese rural elders in nursing homes. The mediating role of resilience in the relationship between social support and HRQOL was confirmed (a*b bootstrapped 95% confidence interval = [0.098, 0.257]), which revealed that social support had an indirect effect on HRQOL through resilience. CONCLUSIONS Resilience partially mediates the relationship between social support and HRQOL. The mediation model provides a better understanding of how social support and resilience work together to affect HRQOL, and it could guide the interventions in health care for promoting HRQOL among Chinese rural elders in nursing homes.
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Wister AV, Coatta KL, Schuurman N, Lear SA, Rosin M, MacKey D. A Lifecourse Model of Multimorbidity Resilience: Theoretical and Research Developments. Int J Aging Hum Dev 2017; 82:290-313. [PMID: 27076489 DOI: 10.1177/0091415016641686] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this article is to advance a Lifecourse Model of Multimorbidity Resilience. It focuses on the ways in which individuals face adversities associated with multimorbidity and regain a sense of wellness through a complex, dynamic phenomenon termed resilience. A comprehensive review of 112 publications (between 1995 and 2015) was conducted using several comprehensive electronic data bases. Two independent researchers extracted and synthesized resilience literature with specific applications to chronic illness. The article outlines five stages of theoretical development of resilience, synthesizes these with the aging and chronic illness literature, builds a rationale for a lifecourse approach to resilience, and applies the model to multimorbidity. Cultivating and maintaining resilience is fundamental to functioning and quality of life for those with multimorbidity. We found that there are a number of gaps in both basic and applied research that need to be filled to advance knowledge and practice based on resilience approaches.
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Affiliation(s)
- Andrew V Wister
- Department of Gerontology, Simon Fraser University, Vancouver, BC, Canada
| | | | - Nadine Schuurman
- Department of Geography, Simon Fraser University, Burnaby, BC, Canada
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Healthy Heart Program, St. Paul's Hospital, Vancouver, BC, Canada
| | - Miriam Rosin
- Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, BC, Canada
| | - Dawn MacKey
- Department of Biomedical Physiology & Kinesiology, Simon Fraser University, Burnaby, BC, Canada
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Cook G, Bailey C, Hodgson P, Gray J, Barron E, McMillan C, Marston R, Binks E, Rose J. Older UK sheltered housing tenants' perceptions of well-being and their usage of hospital services. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:1644-1654. [PMID: 27723175 DOI: 10.1111/hsc.12398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 06/06/2023]
Abstract
The aim of this study was to examine sheltered housing tenants' views of health and well-being, the strategies they adopted to support their well-being, and their use of health and social care services through a Health Needs Assessment. Sheltered housing in the UK is a form of service-integrated housing for people, predominantly over 60. The study used a parallel, three-strand mixed method approach to encompass the tenants' perceptions of health and well-being (n = 96 participants), analysis of the service's health and well-being database, and analysis of emergency and elective hospital admissions (n = 978 tenant data sets for the period January to December 2012). Tenants' perceptions of well-being were seen to reinforce much of the previous work on the subject with strategies required to sustain social, community, physical, economic, environmental, leisure, emotional and spiritual dimensions. Of the tenants' self-reported chronic conditions, arthritis, heart conditions and breathing problems were identified as their most common health concerns. Hospital admission data indicated that 43% of the tenant population was admitted to hospital (886 admissions) with 53% emergency and 47% elective admissions. The potential cost of emergency as opposed to elective admissions was substantial. The mean length of stay for emergency admissions was 8.2 days (median 3.0 days). While elective hospital admission had a mean length of stay of 1.0 day (median 0.0 days). These results suggest the need for multi-professional health, social care and housing services interventions to facilitate sheltered housing tenants' aspirations and support their strategies to live well and independently in their own homes. Equally there is a need to increase tenants' awareness of health conditions and their management, the importance of services which offer facilitation, resources and support, and the key role played by prevention and reablement.
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Affiliation(s)
- Glenda Cook
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Cathy Bailey
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Philip Hodgson
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Joanne Gray
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Emma Barron
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Christine McMillan
- Housing Environment and Leisure, North Tyneside Council, North Tyneside, UK
| | - Roy Marston
- Housing Environment and Leisure, North Tyneside Council, North Tyneside, UK
| | - Eleanor Binks
- Housing Environment and Leisure, North Tyneside Council, North Tyneside, UK
| | - Joanne Rose
- Department of Health Science, York University, York, UK
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Patient Perspectives on Engagement in Recovery after Hip Fracture: A Qualitative Study. J Aging Res 2017; 2017:2171865. [PMID: 28409031 PMCID: PMC5376933 DOI: 10.1155/2017/2171865] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 10/17/2016] [Accepted: 02/26/2017] [Indexed: 11/23/2022] Open
Abstract
Purpose. To understand older adults' engagement in their recovery experience and rehabilitation after a fall-related hip fracture. Method. 50 community-dwelling older adults recovering from a recent (3–12 months) hip fracture (32 women, 18 men) participated in telephone interviews using a semistructured format at 6 and 12 months after recruitment into the study. Interviews were conducted as part of a mixed-methods study designed to test the effect of a postoperative hip fracture management program (B4 Clinic). Results. Three substantive themes were identified in the qualitative data: (1) managing expectations; (2) engaging in physical activity; and (3) there is life after fracture. Participants shared valuable insight into how their expectations for their recovery period compared to their lived experience and the role of physical activity in their ability to return to their prefracture activities. Conclusions. Our findings reflect older adults' expectations for recovery from hip fracture. Encouraging engagement in rehabilitative exercises and addressing expectations prior to hospital discharge may improve patients' adherence to rehabilitation programs, functional outcomes, and postoperative quality of life. Implications for rehabilitation include the necessity for early and ongoing engagement of rehabilitation professionals.
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Hassani P, Izadi-Avanji FS, Rakhshan M, Majd HA. A phenomenological study on resilience of the elderly suffering from chronic disease: a qualitative study. Psychol Res Behav Manag 2017; 10:59-67. [PMID: 28223851 PMCID: PMC5304976 DOI: 10.2147/prbm.s121336] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Resilience is a key factor in improving health and attenuating problems caused by chronic diseases in the elderly. Having a clear understanding of its meaning in a specific population can be of great help in taking efficient steps toward better health services. Given the lack of information in this regard, the aim of this study was to understand the meaning of resilience for hospitalized older people who experience chronic conditions. Methods The study was carried out as a qualitative work based on a descriptive phenomenological approach. The participants were selected purposefully, so that 22 elderly with chronic disease were interviewed in 24 sessions. The collected data were recorded and analyzed through Colaizzi’s method. Results Four themes were extracted from the interviews as follows: 1) “meaning of resilience in the participants’ experiences” with subthemes of “the art of overcoming pain and suffering”, “adapt to health problem of senescence”, “accepting life with the chronic disease”, and “patience and trust in God”; 2) “growth context as a prologue of resilience” with subthemes of “growth background”; 3) “external factors contributing to resilience” with subthemes of “welfare”, “received support”, “deprivation and shortage”, and “attitudes toward an elderly with health problem”; and 4) “personal factors to overcome illness” with subthemes of “enthusiasm for following up the treatment program”, “aversion to physical dependence”, “hope for improvement”, “motivation and purpose”, and “being content with one’s belongings and blessings”. Conclusion Improvement in resilience is associated with a patient-oriented approach. Providers of health services might make proper interventions based on unique needs of patients to improve their resilience and ability to overcome health problems. This can be performed by family members, health team, and related organizations and bodies.
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Affiliation(s)
- Parkhide Hassani
- Department of Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh-Sadat Izadi-Avanji
- Department of Nursing, School of Nursing and Midwifery, International Branch of Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahnaz Rakhshan
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, Facility of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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‘I just want to get on with my life’: a mixed-methods study of active management of quality of life in living with dementia. AGEING & SOCIETY 2016. [DOI: 10.1017/s0144686x16001069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThe active management of the experience of living with dementia appears to improve quality of life despite the lack of disease modification. However, research to date has been largely of modest scale and explanatory factors for improvements have been under-conceptualised. Thus, although promulgated through national strategies, the evidence base is relatively weak. This paper reports on a nation-wide study of the influence of the National Dementia Strategy for England in relation to Dementia Adviser and Peer Support Network services in 40 demonstration sites. The research aimed to identify ways in which the services contribute to the wellbeing and resilience of people with dementia and care partners. A mixed-methods research design collected data through: activity and outcome monitoring; organisational surveys; in-depth case studies, including qualitative interviews with people with dementia (N = 47) and care partners (N = 54), wellbeing and quality of life measures, and interviews with staff and other stakeholders (N = 82). Three themes are explored: addressing individual and community needs; promoting independence, control and choice; and getting a life back. Services promoted independence, control and choice, and consequently enabled people to re-narrate their lives as purposeful within their communities. Ways in which these are achieved resemble the public health model of lay health advisor and this research adds to the imperative to approach dementia as a key public health concern.
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Living on the Edge: Social Exclusion and the Receipt of Informal Care in Older People. J Aging Res 2016; 2016:6373101. [PMID: 27882247 PMCID: PMC5108865 DOI: 10.1155/2016/6373101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 09/04/2016] [Indexed: 11/23/2022] Open
Abstract
Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care is provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion. A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people (n = 1255) living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care-receiver; assurance-receiver; nonreceiver with no need; and nonreceiver with need. Compared to being a nonreceiver with no need, participants were more likely to be care-receivers or assurance-receivers if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in nonreceivers with need. Despite a lack of informal care and support, formal practical support and personal care were also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of nonreceivers with need.
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Dai Y, Zhang CY, Zhang BQ, Li Z, Jiang C, Huang HL. Social support and the self-rated health of older people: A comparative study in Tainan Taiwan and Fuzhou Fujian province. Medicine (Baltimore) 2016; 95:e3881. [PMID: 27310979 PMCID: PMC4998465 DOI: 10.1097/md.0000000000003881] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 05/12/2016] [Accepted: 05/16/2016] [Indexed: 11/27/2022] Open
Abstract
The lack of social support in elderly populations incurs real societal costs and can lead to their poor health. The aim of this study is to investigate the self-rated health (SRH) and social support among older people as well as its associated factors.We conducted a cross-sectional study among 312 urban community-dwelling elderly aged 65 to 90 years in Tainan Taiwan and Fuzhou Fujian Province from March 2012 to October 2012. A Spearson correlation test, independent t test, a Pearson χ test, a linear regression analysis, and a multiple-level model were performed to analyze the results.The participants identified children as the most important source of objective and subjective support, followed by spouse and relatives. Tainan's elderly received more daily life assistance and emotional support, showed stronger awareness of the need to seek help, and maintained a higher frequency of social interactions compared with the elderly in Fuzhou. The mean objective support, subjective support, and support utilization scores as well as the overall social support among Tainan's elderly were significantly high compared with the scores among Fuzhou's elderly. Further, Tainan's elderly rated better SRH than Fuzhou's elderly. Correlation analysis showed that social support was significantly correlated with city, age, living conditions, marital status, and SRH. Multiple linear regression analysis, with social support as a dependent variable, retained the following independent predictors in the final regression model: city (4.792, 95% confidence interval [CI]: 3.068-6.516, P = 0.000), age (-0.805, 95% CI: -1.394 to -0.135, P = 0.013), marital status (-1.260, 95% CI: -1.891 to -0.629, P = 0.000), living conditions (4.069, 95% CI: 3.022-5.116, P = 0.000), and SRH -1.941, 95% CI: -3.194 to -0.688, P = 0.003). The multiple-level model showed that city would impact older people's social support (χ = 5.103, P < 0.001). Marital status (-2.133, 95% CI: -2.768 to -1.499, P = 0.000), education (1.697, 95% CI: 0.589-2.805 P = 0.003), living conditions (4.20, 95% CI: 1.762-6.638, P = 0.000), and SRH (-3.144, 95% CI: -4.502 to -1.727, P = 0.000) were the associated factors. Thus, city, age, marital status, education, living conditions, and SRH might be the associated factors for social support among older people.This study presents some feasible implications for social support improvement in China and in other nations worldwide.
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Affiliation(s)
- Yue Dai
- Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou Fujian Province
- Department of Healthcare Management, School of Public Health, Central South University, Changsha Hunan Province
| | - Chen-Yun Zhang
- Department of Health Policy and Law, School of Public Health, Fujian Medical University
| | - Bao-Quan Zhang
- Department of Neonatology, Fujian Maternal and Child Health, Fuzhou Fujian Province
| | | | - Caixiao Jiang
- Department of Epidemiology and Statistics, School of Public Health, Central South University, Changsha Hunan Province
| | - Hui-Ling Huang
- Department of Gerontology, Union Hospital of Fujian Medical University, Fuzhou Fujian Province, China
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Clarke CL, Bailey C. Narrative citizenship, resilience and inclusion with dementia: On the inside or on the outside of physical and social places. DEMENTIA 2016; 15:434-52. [DOI: 10.1177/1471301216639736] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
There has been little research that addresses the importance of place in enabling resilience and citizenship – most to date focussing on these as a characteristic of the individual. This paper reports on findings from a qualitative study that aimed to explore the everyday experiences of living with dementia within rural and semi-urban communities. Data collection included a sequence of four research diaries and interviews with 13 families living at home with dementia and interviews with service providers and commissioners (a total of 57 diaries, 69 interviews with people living with dementia and 6 interviews with service providers and commissioners). Key themes identified included: Others Knowing and Responding; Socially Withdrawing and Feeling Excluded; Sustaining and Changing Activities; Belonging and Estrangement from Place; Engaging Services and Supports. The study found that familiarity with people and place can be supportive, and these factors support a narrative citizenship in which people can tell a story of inclusion and feeling on the inside. However, this familiarity with place may also create a social barrier and a sense of estrangement, or being on the outside. Narrative citizenship allows us to explore how people with dementia position themselves in relation to others and in so doing, negotiate their own and other’s understandings of dementia. It also allows for people to tell stories about themselves in relation to their sense of belonging in a social and physical place, which augment the personal and political approaches to citizenship and thus offers an approach that enhances individualised yet collective understandings of living with dementia.
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Nwoke MB, Chukwuorji JC, Ebere MO. Number of Dependents, Community Support, and Mental Health in Later Life: Does Gender Make a Difference? Int J Aging Hum Dev 2016; 83:63-87. [PMID: 27147681 DOI: 10.1177/0091415016641691] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined associations of number of dependents and community support with mental health and whether the nature of these associations differs for males and females. Data were obtained from 209 elderly Nigerians using self-report measures. Hierarchical multiple regression (stepwise method) and Hayes regression-based PROCESS approach for tests of moderation were employed in analyzing the data. Results of a hierarchical multiple regression showed that number of dependents predicted mental health for the total sample and for men, but not for women. For the subgroups of men and women, there were significant predictions of mental health by community integration, community participation, and use of community organization, even after controlling for the roles of sociodemographic variables. The hypothesis on the moderation effect of community support on the associations of number of dependents and mental health was also supported. Findings highlighted the importance of addressing gender differences in the role of social capital in mental health.
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Affiliation(s)
- Mary Basil Nwoke
- Department of Psychology, University of Nigeria, Nsukka, Nigeria
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Ring A, Jacoby A, Baker GA, Marson A, Whitehead MM. Does the concept of resilience contribute to understanding good quality of life in the context of epilepsy? Epilepsy Behav 2016; 56:153-64. [PMID: 26895477 DOI: 10.1016/j.yebeh.2016.01.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/31/2015] [Accepted: 01/02/2016] [Indexed: 12/15/2022]
Abstract
A significant body of research highlights negative impacts of epilepsy for individual quality of life (QOL). Poor seizure control is frequently associated with reporting of poor QOL and good seizure control with good QOL; however, this is not a universal finding. Evidence suggests that some people enjoy good QOL despite ongoing seizures while others report poor QOL despite good seizure control. Understanding the factors that influence QOL for people with epilepsy and the processes via which such factors exert their influence is central to the development of interventions to support people with epilepsy to experience the best possible QOL. We present findings of a qualitative investigation exploring influences and processes on QOL for people with epilepsy. We describe the clinical, psychological, and social factors contributing to QOL. In particular, we focus on the value of the concept of resilience for understanding quality of life in epilepsy. Based on our analysis, we propose a model of resilience wherein four key component sets of factors interact to determine QOL. This model reflects the fluid nature of resilience that, we suggest, is subject to change based on shifts within the individual components and the interactions between them. The model offers a representation of the complex influences that act and interact to either mitigate or further compound the negative impacts of epilepsy on individual QOL.
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Affiliation(s)
- Adele Ring
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK
| | - Ann Jacoby
- Department of Public Health & Policy, University of Liverpool, Liverpool, UK.
| | - Gus A Baker
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
| | - Anthony Marson
- Department of Molecular & Clinical Pharmacology, University of Liverpool, UK
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Aburn G, Gott M, Hoare K. What is resilience? An Integrative Review of the empirical literature. J Adv Nurs 2016; 72:980-1000. [PMID: 26748456 DOI: 10.1111/jan.12888] [Citation(s) in RCA: 249] [Impact Index Per Article: 31.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2015] [Indexed: 11/29/2022]
Abstract
AIM To use systematic methods to examine how resilience is defined in empirical research. BACKGROUND Resilience is a term that is increasingly being used to describe and explain the complexities of individual and group responses to traumatic and challenging situations. It is now frequently mentioned in relation to many areas of nursing practice, including research. Given the increasing use of the term, it is timely to examine how resilience has been defined in empirical research. DESIGN An integrative review of the empirical literature (2000-2015). DATA SOURCES Three health-related databases were searched: Medline, PsycINFO and the Cumulative Index for Nursing and Allied Health (CINAHL). Reference and citation tracking was performed on all articles included in the review. REVIEW METHODS The methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis. RESULTS One hundred articles were included in the final data analysis. The most significant finding of the review was that there is no universal definition of resilience. There were, however, some common themes identified: rising above, adaptation and adjustment, dynamic process, 'ordinary magic' and mental illness as a marker of resilience. CONCLUSION Despite the increasing use of the term 'resilience', this review has identified that there is no universal definition of resilience adopted in the research literature. Further research is required to explore this construct in the context of nursing.
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Affiliation(s)
- Gemma Aburn
- Paediatric Palliative Care, Starship Children's Health, Auckland, New Zealand.,School of Nursing, University of Auckland, New Zealand
| | | | - Karen Hoare
- School of Nursing, University of Auckland, New Zealand.,Greenstone Family Clinic, Auckland, New Zealand
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de São José J, Barros R, Samitca S, Teixeira A. Older persons' experiences and perspectives of receiving social care: a systematic review of the qualitative literature. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:1-11. [PMID: 25660372 DOI: 10.1111/hsc.12186] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2014] [Indexed: 06/04/2023]
Abstract
The topic of social care for older people has gained increasing attention from the part of academics, professionals, policy makers and media. However, we know little about this topic from the perspectives of older persons, which hinders future developments in terms of theory, empirical research, professional practice and social policy. This article presents and discusses a systematic review of relevant qualitative research-based evidence on the older persons' experiences and perspectives of receiving social care published between 1990 and September 2014. This review aimed to obtain answers to the following questions: How is the reception of social care experienced by the older persons? What are the negative and positive aspects of these experiences? What are the factors which influence the experiences? The synthesis of the findings of reviewed papers identified six analytical themes: asking for care as a major challenge; ambivalences; (dis)engagement in decisions concerning care; multiple losses as outcomes of receiving social care; multiple strategies to deal with losses originated by the ageing process; and properties of 'good care'. These themes are discussed from the point of view of their implications for theory, care practice and social policy, and future research.
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Affiliation(s)
- José de São José
- Faculty of Economics, University of Algarve, Research Centre for Spatial and Organizational Dynamics, Faro, Portugal
| | - Rosanna Barros
- School of Education and Communication, University of Algarve, Faro, Portugal
| | - Sanda Samitca
- Institute of Social Sciences, University of Lisbon, Lisbon, Portugal
| | - Ana Teixeira
- Faculty of Economics, University of Algarve, Research Centre for Spatial and Organizational Dynamics, Faro, Portugal
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Ponce-Garcia E, Madewell AN, Kennison SM. The Development of the Scale of Protective Factors: Resilience in a Violent Trauma Sample. VIOLENCE AND VICTIMS 2015; 30:735-755. [PMID: 26300467 DOI: 10.1891/0886-6708.vv-d-14-00163] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This research developed the Scale of Protective Factors (SPF-24) to measure protective factors contributing to resilience. We investigated the factor structure of 35 items. After exploratory factor analysis, we subjected 25 items representing 2 social-interpersonal and 2 cognitive-individual factors to confirmatory factor analysis. The sample consisted of 942 college students from 3 studies and 2 institutions. To examine the diagnostic function of the SPF, we used clinical criteria to identify a subsample of participants who had experienced violent trauma and scored low, moderate, or high on an established resilience scale. Results showed that the low-resilient group scored significantly lower on all subscales of the SPF with marked differences in prioritizing/planning behavior. Implications for the research and clinical settings are discussed.
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van Beljouw IMJ, Heerings M, Abma TA, Laurant MGH, Veer-Tazelaar PJV, Baur VE, Stek ML, van Marwijk HWJ, Van Exel E. Pulling out all the stops: what motivates 65+ year olds with depressive symptoms to participate in an outreaching preference-led intervention programme? Aging Ment Health 2015; 19:453-63. [PMID: 25215904 DOI: 10.1080/13607863.2014.944090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Many older adults have significant depressive symptoms but few people access care for these. This study explores which personal, clinical and need factors facilitate or hinder acceptance of a new outreaching preference-led intervention programme. METHODS From a sample of 9661 community-dwelling 65+ year olds, 244 persons with depressive symptoms according to the Patient Health Questionnaire-9 were included. Data on programme effectiveness in terms of care utilisation were collected. Associations between programme acceptance and personal, clinical and need factors were studied using quantitative (logistic regression analyses) and qualitative methods (semi-structured interviews with 26 subjects, who accepted (n = 20) or declined (n = 6) the programme). RESULTS Fifty-six per cent (n = 137) took part in the interventions. Quantitative logistic regression analyses showed that participants were more often female, suffered from more severe depressive symptoms and perceived more loneliness. Qualitative analyses revealed that people accepting the intervention programme felt that medical terms as having a depressed mood were applicable to their situation, more often perceived their symptoms as hindering, felt lonely and more often perceived a need for care. They were more often advised by their general practitioner to participate than individuals who refused the interventions. Many participating individuals did not see a match between the intervention programme and their needs, especially with respect to meeting new people. CONCLUSION Many older persons with depressive symptoms did not feel the need to take part in the programme. Providing support in alleviating loneliness and further adaptation to older adults' illness representations and perceptions when discussing depressive symptoms might enhance care utilisation.
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Affiliation(s)
- Ilse M J van Beljouw
- a Department of Psychiatry , VU University Medical Center/GGZ in Geest and EMGO+ Institute for Health and Care Research , Amsterdam , The Netherlands
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