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Burton E, Chonody J, Teater B, Alford S. Goal setting in later life: an international comparison of older adults' defined goals. BMC Geriatr 2024; 24:443. [PMID: 38773405 PMCID: PMC11110366 DOI: 10.1186/s12877-024-05017-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: 01/29/2024] [Accepted: 04/26/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND Studies of goal setting in later life tend to focus on health-related goal setting, are pre-determined by the researcher (i.e., tick box), and/or are focused on a specific geographical area (i.e., one country). This study sought to understand broader, long-term goals from the perspective of older adults (65 + years) from Australia, New Zealand (NZ), United Kingdom (UK), Ireland, Canada, and the United States of America (USA). METHODS Through a cross-sectional, online survey (N = 1,551), this exploratory study examined the qualitative goal content of older adults. Thematic analysis was used to analyze the qualitative data, and bivariate analyses were used to compare thematic differences between regions and by participants' sex. RESULTS Over 60% of the participants reported setting goals, and participants from the Australia-NZ and Canada-USA regions were more likely to set goals than the UK-Ireland region. The following six overarching themes were identified from the 946 goals reported: health and well-being; social connections and engagement; activities and experiences; finance and employment; home and lifestyle; and attitude to life. CONCLUSIONS This study supports previous research that demonstrates that older adults can and do set personal goals that are wide ranging. These findings support the need for health professionals to consider different methods for elucidating this important information from older adults that builds rapport and focuses on aspects viewed as more important by the older adult and therefore potentially produces improved health outcomes.
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Affiliation(s)
- Elissa Burton
- enAble Institute, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA, Australia.
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
| | - Jill Chonody
- College of Health Sciences, School of Social Work, Boise State University, Boise, ID, USA
| | - Barbra Teater
- College of Staten Island, Department of Social Work, City University of New York, Staten Island, NY, USA
| | - Sabretta Alford
- The Graduate Center, PhD in Social Welfare, City University of New York, New York, NY, USA
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Kattouw CE, Aase K, Viksveen P. How do the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home? A qualitative interview study with multiple stakeholders. FRONTIERS IN HEALTH SERVICES 2024; 4:1294320. [PMID: 38577152 PMCID: PMC10991764 DOI: 10.3389/frhs.2024.1294320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 03/11/2024] [Indexed: 04/06/2024]
Abstract
Introduction Often, homecare services are task-focused rather than person-based and fragmented instead of integrated. Consequently, several stakeholders have requested a transformation of the service ecosystem for senior citizens living at home. This transformation may be facilitated by an idealized design approach. However, few studies have applied such an approach. Moreover, previous research did not assess the ways in which the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home. Therefore, the purpose of this study is to gain an understanding of how the existing homecare services correspond with the preferred service ecosystem for senior citizens living at home, according to different stakeholders. Methods Four stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study (2019-2020): senior citizens, carers, healthcare professionals and managers. A directed qualitative content analysis was applied, guided by a four-category framework for the preferred service ecosystem. Results All stakeholder groups highlighted several limitations that hindered continuity of the services. There was also agreement on deficiencies in professionals' competence, yet professionals themselves did not focus on this as a significant aspect. Managers emphasised the importance of professionals' reablement competence, which was also considered to be deficient in the current homecare services. Contrary to the other stakeholder groups, most senior citizens seemed satisfied with the practical and social support they received. Together with carers, they also explained why they thought some professionals lack compassion. Their dependency on professionals may limit them in sharing honestly their opinions and preferences during care provision. Involvement of senior citizens in improvement of the current services was limited. Insufficient time and resources, as well as a complex organisation impacted the existing homecare services, and therefore served as barriers to the preferred service ecosystem. Discussion In this study there were different degrees of correspondence between the existing homecare services and the preferred service ecosystem according to four stakeholder groups. To develop the preferred service ecosystem, aspects such as predictability, adaptivity, and relationships are key, as well as continuous involvement of senior citizens and other stakeholders. The four-category framework applied in this study served as a tool to assess the existing homecare services.
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Affiliation(s)
- Christophe Eward Kattouw
- SHARE—Centre for Resilience in Healthcare, Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Yang JM, Kim JH, Hwang JE. Effect of intensity of persistent social isolation on mental health in the late middle-aged and older population: results of the Korea Longitudinal Study of Ageing (2006-2020). Psychogeriatrics 2024; 24:391-403. [PMID: 38339804 DOI: 10.1111/psyg.13085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/28/2023] [Accepted: 01/16/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Social isolation (SI) was recently identified as a significant public health issue in the United States. Consequently, several studies on the association between SI and mental health were conducted. However, few studies have considered the duration and intensity of SI. In the present study, a longitudinal analysis was conducted to determine the effect of the intensity of persistent SI on the mental health status of late middle-aged and older Koreans. METHODS After excluding missing values, data on 6200 participants were analyzed using the group-based trajectory model (GBTM) from the first to fifth Korean Longitudinal Study of Ageing (KLoSA) to categorise the SI trajectory (SIT). The Chi-square test, t-test, analysis of variance, and time-lagged generalised estimation equations were utilised from the fifth to eighth KLoSA to determine the association between SIT and the incidence of cognitive decline (the group with a Korean version Mini-Mental State Examination score of 23 or lower), cognitive function score, and depression score. RESULTS Four SIT groups were identified in the GBTM analysis. These were the non-SIT (21.7%), mild (46.8%), moderate (21.1%), and severe SIT (10.4%) groups. Compared to the non-SIT group, the severe SIT group experienced a greater incidence of cognitive decline (odds ratio = 1.57, P < 0.0001) as well as poorer cognitive function scores (B = -0.63, P < 0.0001) and depression scores (B = 0.90, P < 0.0001). Furthermore, stratified analysis by sex and age showed that mental health status was inversely proportionate to the intensity of SIT, particularly in males and patients, aged 65 years and above. CONCLUSION A close association was observed between SIT and mental health. This finding highlighted the need for policies and institutional measures to reduce the incidence of mental health deterioration among vulnerable groups due to the intensity of SI.
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Affiliation(s)
- Jeong Min Yang
- Department of Public Health, General Graduate School of Dankook University, Cheonan, Republic of Korea
| | - Jae Hyun Kim
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
| | - Ji Eun Hwang
- Department of Health Administration, College of Health Science, Dankook University, Cheonan, Republic of Korea
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Adam CE, Fitzpatrick AL, Leary CS, Ilango SD, Phelan EA, Semmens EO. The impact of falls on activities of daily living in older adults: A retrospective cohort analysis. PLoS One 2024; 19:e0294017. [PMID: 38170712 PMCID: PMC10763967 DOI: 10.1371/journal.pone.0294017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 10/25/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Falls contribute to impairments in activities of daily living (ADLs), resulting in significant declines in the quality of life, safety, and functioning of older adults. Understanding the magnitude and duration of the effect of falls on ADLs, as well as identifying the characteristics of older adults more likely to have post-fall ADL impairment is critical to inform fall prevention and post-fall intervention. The purpose of this study is to 1) Quantify the association between falls and post-fall ADL impairment and 2) Model trajectories of ADL impairment pre- and post-fall to estimate the long-term impact of falls and identify characteristics of older adults most likely to have impairment. METHOD Study participants were from the Ginkgo Evaluation of Memory Study, a randomized controlled trial in older adults (age 75+) in the United States. Self-reported incident falls and ADL scores were ascertained every 6 months over a 7-year study period. We used Cox proportional hazards analyses (n = 2091) to quantify the association between falls and ADL impairment and latent class trajectory modeling (n = 748) to visualize trajectories of ADL impairment pre-and post-fall. RESULTS Falls reported in the previous 6 months were associated with impairment in ADLs (HR: 1.42; 95% CI 1.32, 1.52) in fully adjusted models. Based on trajectory modeling (n = 748), 19% (n = 139) of participants had increased, persistent ADL impairment after falling. Participants who were female, lived in a neighborhood with higher deprivation, or experienced polypharmacy were more likely to have ADL impairment post-fall. CONCLUSIONS Falls are associated with increased ADL impairment, and this impairment can persist over time. It is crucial that all older adults, and particularly those at higher risk of post-fall ADL impairment have access to comprehensive fall risk assessment and evidence-based fall prevention interventions, to help mitigate the negative impacts on ADL function.
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Affiliation(s)
- Claire E. Adam
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Annette L. Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Cindy S. Leary
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
| | - Sindana D. Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Elizabeth A. Phelan
- Division of Gerontology and Geriatric Medicine, School of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Erin O. Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, Montana, United States of America
- Center for Population Health Research, University of Montana, Missoula, Montana, United States of America
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Kim J, Park GR. Prolonged social isolation and cognitive function in older adults: lack of informal social contact versus formal social activity as the source of social isolation. Aging Ment Health 2023; 27:2438-2445. [PMID: 37079761 DOI: 10.1080/13607863.2023.2202616] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 04/04/2023] [Indexed: 04/22/2023]
Abstract
OBJECTIVES This study investigates the cognitive function trajectories associated with prolonged social isolation, while distinguishing between a lack of informal social contact and a lack of formal social activity as the source of social isolation. METHODS Data from the Korean Longitudinal Study of Ageing spanning 12 years between 2006 and 2018 were analyzed. A lack of frequent informal social contact or formal social activity was used to assess social isolation, and cognitive function was measured by Korean Mini-Mental State Examination. Fixed effects regression models were used to account for unobserved individual-level confounders. RESULTS A prolonged absence of frequent informal social contact was linked to a decline in cognitive function up to the three waves of exposure (b = -2.135), but cognitive function has not declined further since then. A persistent lack of formal social activity was associated with a decline in cognitive function up to the fifth and subsequent waves of exposure (b = -3.073). No gender differences were observed in these relationships. CONCLUSION Prolonged social isolation, particularly a lack of formal social activity, can pose a significant threat to the cognitive health of older adults.
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Affiliation(s)
- Jinho Kim
- Department of Health Policy and Management, Korea University, Seoul, Republic of Korea
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, Republic of Korea
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Gum-Ryeong Park
- Department of Health, Aging & Society, McMaster University, Ontario, Canada
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Kattouw CE, Aase K, Viksveen P. Stakeholder perspectives on the preferred service ecosystem for senior citizens living at home: a qualitative interview study. BMC Geriatr 2023; 23:576. [PMID: 37726648 PMCID: PMC10508029 DOI: 10.1186/s12877-023-04303-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 09/09/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Most senior citizens want to live independently at home as long as possible. The World Health Organization recommends an age-friendly community approach by transforming the service ecosystem for senior citizens and basing it on the question "What matters to you?". However, there is limited research-based knowledge to determine the characteristics of the preferred service ecosystem from the perspectives of multiple stakeholders. Therefore, the aim of the study was to gain a deeper understanding of multiple stakeholder perspectives on the preferred service ecosystem for senior citizens living at home. METHODS Four stakeholder groups (n = 57) from a Norwegian municipality participated in an interview study in 2019 and 2020: senior citizens, carers, healthcare professionals, and managers. Data were analysed according to qualitative content analysis. RESULTS Overall, there was considerable correspondence between the four stakeholder groups' perspectives on the preferred service ecosystem for senior citizens. Six themes were developed: (1) "self-reliance - living independently at home as long as possible"; (2) "remaining active and social within the community"; (3) "support for living at home as long as possible"; (4) "accessible information and services"; (5) "continuity of services"; and (6) "compassionate and competent healthcare professionals". CONCLUSIONS In order to adapt and meet changing needs, the preferred service ecosystem should support senior citizens' autonomy through interpersonal relationships and involvement. Healthcare managers and decision makers should consider a broader range of practical and social support services. Municipalities should plan for and develop age-friendly infrastructures, while healthcare professionals should rely on their compassion and competence to meet senior citizens' needs.
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Affiliation(s)
- Christophe Eward Kattouw
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway.
| | - Karina Aase
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
| | - Petter Viksveen
- Department of Quality and Health Technology, Faculty of Health Sciences, SHARE - Centre for Resilience in Healthcare, University of Stavanger, Post Box 8600, Forus, Stavanger, 4036, Norway
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Terrell CA, Martins SL, Delkoski SL, Torkelson CJ. What Do Women Want? Identifying Life Goals in a Community-Based Sample of Women Aged ≥60 Years. J Gerontol Nurs 2022; 48:25-33. [DOI: 10.3928/00989134-20221108-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Chen Y, Weziak-Bialowolska D, Lee MT, Bialowolski P, McNeely E, VanderWeele TJ. Longitudinal associations between domains of flourishing. Sci Rep 2022; 12:2740. [PMID: 35177714 PMCID: PMC8854559 DOI: 10.1038/s41598-022-06626-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 01/24/2022] [Indexed: 12/18/2022] Open
Abstract
The longitudinal interrelationships between domains of human well-being or flourishing remain understudied empirically. While different aspects of flourishing may be sought as their own end, it is also the case that well-being in one domain may influence well-being in other domains. Using longitudinal data form a sample of employees from a large national employer in the United States (N = 1209, mean age = 43.52 years, age range 20-74 years), this study examined the temporal associations between various domains of flourishing, based on a 40-item index that assessed six domains of flourishing. These domains include emotional health, physical health, meaning and purpose, character strengths, social connectedness, and financial security. A set of linear regression models were used to regress subsequent composite flourishing on flourishing domain-specific scores at baseline. The results indicated that all domains were each independently associated with greater composite flourishing subsequently. The strongest and most robust links were observed for meaning and purpose (β = 0.19, 95% confidence interval [CI] 0.13, 0.25), social connectedness (β = 0.17, 95% CI 0.12, 0.22), and financial security (β = 0.32, 95% CI 0.28, 0.37). Further analyses that regressed subsequent composite flourishing on individual item indicators at baseline suggested that, out of all 40 items, one item under the character domain "I always act to promote good in all circumstances, even in difficult and challenging situations" and one item in the physical health domain ("Based on my past health, I expect to be healthy long into the future") had the most robust association with subsequent composite flourishing. Implications of these results for understanding the constituents of a flourishing life and for refinement of the flourishing assessments are discussed.
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Affiliation(s)
- Ying Chen
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Dorota Weziak-Bialowolska
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Matthew T Lee
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA
| | - Piotr Bialowolski
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eileen McNeely
- Sustainability and Health Initiative (SHINE), Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Hennecke M, Brandstätter V, Oettingen G. The Self-Regulation of Healthy Aging: Goal-Related Processes in Three Domains. J Gerontol B Psychol Sci Soc Sci 2021; 76:S125-S134. [PMID: 34515771 DOI: 10.1093/geronb/gbab011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Indexed: 11/14/2022] Open
Abstract
As people age, they experience typical age-graded challenges and opportunities, for example, their own retirement, changes in their social networks, or a decline in health condition. The extent to which people successfully process, respond to, and act on these challenges and opportunities is highly important for their health, at the core of which the WHO sees the possibility of "doing what one has reason to value." In this article, we posit that individuals can play an active role in determining whether they can, in response to these age-graded influences, continue doing what they have reason to value, and that they can do so by deploying the self-regulatory processes of goal setting (including reengagement in new goals after disengaging from a previous goal), goal pursuit, and goal disengagement. We discuss the role of these self-regulatory processes in three important goal domains: work/retirement, interpersonal relationships, and health. Across these domains, we consider typical challenges and opportunities including the increased availability of daily time in old age, the long past that lies behind older adults, and their limited future time perspective. Finally, we derive open research questions that may be studied to better understand how the very old may self-regulate their response to age-graded influences.
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Affiliation(s)
| | | | - Gabriele Oettingen
- Department of Psychology, New York University, USA.,Department of Psychology, Universität Hamburg, Germany
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Portegijs E, Saajanaho M, Leppä H, Koivunen K, Eronen J, Rantanen T. Impact of mobility restrictions on active aging; cross-sectional associations and longitudinal changes parallel to COVID-19 restrictions. Arch Gerontol Geriatr 2021; 98:104522. [PMID: 34638047 DOI: 10.1016/j.archger.2021.104522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Meaningful activities can be done in or around home, but opportunities for participation and active aging decrease when moving in smaller areas. Active aging refers to having an active approach to life in line with one's goals, ability and opportunities. In adults over 75 years with different baseline neighborhood mobility levels, we studied active aging scores two years prior to and amid COVID-19, when governments restricted mobility of residents to slow the COVID-19 outbreak. METHODS AGNES cohort data were collected in 2017-2018 and spring 2020. Individuals were queried about their will, ability, and opportunity, and extent of doing 17 activities, and subsequently, item, composite and sub-scores of active aging were computed. Neighborhood mobility was assessed as frequency of moving in or beyond own neighborhood (limited, regular, daily=reference). Associations were studied using Generalized Linear Models (cross-sectionally, n = 1007) and General Estimating Equations (prospectively, n = 774). RESULTS Participants with limited baseline neighborhood mobility had lower active aging scores than those with daily mobility, but the decline over time was similar. Some item scores on opportunity to act and extent of doing, e.g. for making one's day more interesting and advancing matters of faith or worldview, were better retained amid COVID-19 by those with limited mobility, attenuating group differences. CONCLUSIONS Active aging scores were somewhat compromised in individuals with limited neighborhood mobility, but opportunities for and engagement in several activities seemed to be better retained amid COVID-19 than for those with daily mobility. Thus, active aging may be possible despite mobility restriction.
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Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland.
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Heidi Leppä
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Kaisa Koivunen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Johanna Eronen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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Tan JY, Tam WSW, Goh HS, Ow CC, Wu XV. Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long-term care: A correlational study using the salutogenic model. J Adv Nurs 2021; 77:4471-4489. [PMID: 34142732 DOI: 10.1111/jan.14940] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 05/14/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
AIMS This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long-term care setting. DESIGN A cross-sectional, descriptive correlational study. METHOD The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor-Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument-older adults (WHOQOL-OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product-moment correlation coefficient, independent-samples t test, one-way analysis of variance and stepwise regression were utilised in the analysis. RESULTS The mean score for WHOQOL-OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL. CONCLUSION Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long-term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention. IMPACT Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.
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Affiliation(s)
- Jia Yi Tan
- Singapore General Hospital, Singapore, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hongli Sam Goh
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Aartolahti E, Eronen J, Törmäkangas T, Rantanen T, Hirvensalo M, Palmberg L, Skantz H, Viljanen A, Portegijs E, Iwarsson S, Rantakokko M. Perceived Opportunities for Physical Activity and Willingness to Be More Active in Older Adults with Different Physical Activity Levels. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6146. [PMID: 34200182 PMCID: PMC8201061 DOI: 10.3390/ijerph18116146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/31/2021] [Accepted: 06/04/2021] [Indexed: 01/03/2023]
Abstract
This study examined equity in physical activity (PA) by investigating whether perceived opportunity for PA was associated with willingness to be more active. Among community residents (75, 80, or 85 years old, n = 962) perceived opportunity for PA (poor and good), willingness to be more active (not at all, a bit, and a lot), and level of PA (low, moderate, and high) were assessed via questionnaires. Multinomial logistic regression showed that physical activity moderated the association between poor opportunity and willingness to increase PA. Among those with moderate PA, poor opportunity for PA increased the odds of willingness to be a lot more active (multinomial odds ratio, mOR 3.90, 95% confidence interval 2.21-6.87) than not wanting to be more active compared to those perceiving good opportunities. Associations were similar at high PA levels (p < 0.001), but were not found at low PA levels. Those with moderate or high PA wish to increase their activity particularly when the perceived opportunities for activity are not optimal. Among those with low PA, perceived opportunities are not associated with a perceived need to increase physical activity. Increasing equity in physical activity in old age requires provision of support and opportunities at every level of physical activity.
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Affiliation(s)
- Eeva Aartolahti
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Institute of Rehabilitation, JAMK University of Applied Sciences, FI-40100 Jyväskylä, Finland;
| | - Johanna Eronen
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Timo Törmäkangas
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Mirja Hirvensalo
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
| | - Lotta Palmberg
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Heidi Skantz
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Anne Viljanen
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Erja Portegijs
- Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland; (J.E.); (T.T.); (T.R.); (M.H.); (L.P.); (H.S.); (A.V.); (E.P.)
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, FI-40014 Jyväskylä, Finland
| | - Susanne Iwarsson
- Department of Health Sciences & Centre for Ageing and Supportive Environments (CASE), Lund University, SE-22100 Lund, Sweden;
| | - Merja Rantakokko
- Institute of Rehabilitation, JAMK University of Applied Sciences, FI-40100 Jyväskylä, Finland;
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13
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Siltanen S, Tourunen A, Saajanaho M, Palmberg L, Portegijs E, Rantanen T. Psychological resilience and active aging among older people with mobility limitations. Eur J Ageing 2021; 18:65-74. [PMID: 33746682 PMCID: PMC7925737 DOI: 10.1007/s10433-020-00569-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Active aging refers to striving for well-being through preferred activity and may be restricted with declining mobility. We investigated whether psychological resilience, i.e., the ability to tolerate hardship, can aid older people in being active despite mobility limitations. Participants were 961 community-dwelling persons aged 75, 80, or 85 years living in Jyväskylä, Central Finland. Mobility limitations were indicated as self-reported difficulty in walking 2 km. Categories were no difficulty (reference), difficulty, and unable to walk. Resilience was assessed with the 10-item Connor-Davidson Resilience Scale and active aging with the University of Jyvaskyla Active Aging scale. Data were analyzed with OLS regression analyses, which were stratified by age. In all age-groups, having difficulties walking or being unable to walk 2 km was associated with lower active aging scores. Resilience moderated this association especially among the 75-year-olds, but not among the 85-year-olds: The higher the resilience score, the higher the active aging score among those reporting no or some walking difficulties. Those unable to walk 2 km had lower active aging scores irrespective of resilience level. Psychological resilience may alleviate the negative effects of early phase walking difficulties on active aging but may be insufficient to compensate for more severe walking limitations that restrict not only function but also autonomy.
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Affiliation(s)
- Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Anu Tourunen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Lotta Palmberg
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, PO Box 35, 40014 Jyvaskyla, Finland
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14
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Portegijs E, Keskinen KE, Tuomola EM, Hinrichs T, Saajanaho M, Rantanen T. Older adults' activity destinations before and during COVID-19 restrictions: From a variety of activities to mostly physical exercise close to home. Health Place 2021; 68:102533. [PMID: 33647634 PMCID: PMC9185126 DOI: 10.1016/j.healthplace.2021.102533] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/09/2021] [Accepted: 02/09/2021] [Indexed: 11/25/2022]
Abstract
The aim was to study various types of older adult's activity destinations (counts, frequency of visitation, and distance from home) in the pre-COVID-19 era, and to study prospectively how COVID-19-related regulations limiting mobility affected these. Using a map-based questionnaire, 75-85-year-old participants reported activity destinations, that is, any destinations for physical exercise, destinations facilitating one's outdoor mobility, and destinations for other activities, which they had visited several times during the past month. At baseline, a variety of activity destinations was reported, but during COVID-19, destinations reported markedly declined in number, they were reported predominantly for physical exercise, and they were located closer to home.
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Affiliation(s)
- Erja Portegijs
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland.
| | - Kirsi E Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Essi-Mari Tuomola
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Timo Hinrichs
- Division of Sports and Exercise Medicine, Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
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15
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Chen Y, Kim ES, Shields AE, VanderWeele TJ. Antecedents of Purpose in Life: Evidence from A Lagged Exposure-Wide Analysis. COGENT PSYCHOLOGY 2020; 7. [PMID: 33072817 DOI: 10.1080/23311908.2020.1825043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Potential antecedents to having a sense of purpose in life remain understudied. As researchers begin contemplating purpose as a promising target of public health intervention, it is critical to identify its antecedents. Using prospective data from the Nurses' Health Study II (2009-2016; N ranged from 3,905 to 4,189), this study evaluated a wide range of potential antecedents of purpose, including: psychosocial well-being, psychological distress, employment characteristics, lifestyle, and physical health factors. In separate regression models we regressed purpose in life on each candidate antecedent. In each model, we adjusted for the prior value of purpose, prior values of all exposure variables, and various other covariates simultaneously. Bonferroni correction was used to correct for multiple testing. The results suggested that positive affect and the number of close relatives were each associated with higher purpose (e.g., β=0.14, 95% CI: 0.11, 0.17 for positive affect). Several psychological distress indicators were inversely associated with purpose, including depressive symptoms, anxiety symptoms, loneliness, and hopelessness (e.g., β=-0.16, 95% CI: -0.19, -0.13 for depressive symptoms). There was also some evidence suggesting that fewer close friends, living alone, and unemployment/retirement were associated with lower purpose. There was, however, little evidence that health behaviors or physical health were associated with subsequent purpose. This study extends the literature by providing longitudinal evidence with rigorous analytic methodologies, and by considering a wide range of potential antecedents of purpose including some that have seldom been examined previously.
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Affiliation(s)
- Ying Chen
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric S Kim
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Alexandra E Shields
- Department of Medicine, Harvard Medical School, Boston, MA; Harvard/MGH Center on Genomics, Vulnerable Populations, and Health Disparities, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - Tyler J VanderWeele
- Human Flourishing Program, Harvard Institute for Quantitative Social Science, Cambridge, MA, USA.,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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16
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Rantanen T, Hassandra M, Pynnönen K, Siltanen S, Kokko K, Karavirta L, Kauppinen M, Sipilä S, Saajanaho M, Portegijs E. The effect of individualized, theory-based counselling intervention on active aging and quality of life among older people (the AGNES intervention study). Aging Clin Exp Res 2020; 32:2081-2090. [PMID: 32239460 PMCID: PMC7532961 DOI: 10.1007/s40520-020-01535-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 03/12/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND We define active aging as a striving for activities as per one's goals, capacities and opportunities. AIM To test the 1-year counselling intervention effects on active aging. METHODS In this two-arm single-blinded randomized controlled trial, the intervention group received individually tailored counselling supporting autonomous motivation for active life (one face-to-face session, four phone calls and supportive written material, n = 101) and the control group written health information (n = 103). Participants were community-dwelling men and women aged 75 or 80 years with intermediate mobility function and without cognitive impairment. The primary outcome was active aging total score measured with the University of Jyväskylä Active Aging Scale (UJACAS, range 0-272, higher values indicate more activity) and secondary outcomes were its subscores for goals, ability, opportunity and activity (range 0-68) and a quality of life (QoL) score. Measures took place at pre-trial, mid-trial (6 months) and post-trial (12 months), except for QoL only pre and post-trial. Data were analyzed with intention-to-treat principles using GEE-models. RESULTS The UJACAS total score increased in the intervention group slightly more than in the control group (group by time p-value = 0.050, effect size 0.011, net benefit 2%), but the group effect was not statistically significant. A small effect was observed for the activity subscore (p = 0.007). DISCUSSION The individualized counselling supporting autonomous motivation for active life increased the UJACAS score slightly. CONCLUSIONS It may be possible to promote active aging with individualized counselling, but the effect is small and it is unclear whether the change is meaningful.
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Affiliation(s)
- Taina Rantanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland.
| | - Mary Hassandra
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Pynnönen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Sini Siltanen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Katja Kokko
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Laura Karavirta
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Markku Kauppinen
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Sarianna Sipilä
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Milla Saajanaho
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
| | - Erja Portegijs
- Faculty of Sport and Health Sciences, Gerontology Research Center, University of Jyväskylä, Jyväskylä, Finland
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17
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Skantz H, Rantanen T, Rantalainen T, Keskinen KE, Palmberg L, Portegijs E, Eronen J, Rantakokko M. Associations between Perceived Outdoor Environment and Walking Modifications in Community-Dwelling Older People: A Two-Year Follow-Up Study. J Aging Health 2020; 32:1538-1551. [PMID: 32720836 PMCID: PMC8688982 DOI: 10.1177/0898264320944289] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives: To examine associations of perceived outdoor environment with the prevalence and development of adaptive (e.g., slower pace) and maladaptive (e.g., avoiding walking) modifications in walking 2 km among older people. Methods: Community-dwelling 75-90 -year-old persons (N = 848) reported environmental outdoor mobility facilitators and barriers at baseline. Modifications in walking 2 km (adaptive, maladaptive, or no) were assessed at baseline and one and two years later. Results: Outdoor mobility facilitators were more often reported by those not using modifications or using adaptive versus maladaptive walking modifications. Differences in health and physical capacity explained most of the associations between outdoor mobility barriers and walking modifications. Perceived outdoor environment did not systematically predict future adaptive or maladaptive walking modifications. Discussion: Facilitators may compensate the declined physical capacity and alleviate the strain of walking longer distances by enabling the use of adaptive walking modifications, while lack of such facilitators fuels avoidance of walking longer distances.
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18
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Baker N, Lawn S, Gordon SJ, George S. Older Adults' Experiences of Goals in Health: A Systematic Review and Metasynthesis. J Appl Gerontol 2020; 40:818-827. [PMID: 32396500 DOI: 10.1177/0733464820918134] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To synthesize older adults' experiences and perceptions of goal setting and pursuit within health systems. Methods: Six databases were searched to May 2019 using a combination of MeSH and free text terms. Included papers were written in English and reported original qualitative research for participants aged 65 years and older. Participant quotes from the results sections of included studies were gathered for thematic analysis and synthesis. Results: Initial search yielded 9,845 articles, and 134 were identified for full-text review. Fifteen papers were included in the final synthesis. Two main themes were identified: enablers (intrinsic and extrinsic) and barriers (personal and system). Conclusion: Older adults' self-belief is the strongest enabler for goal activities, enhanced by a personalized coaching approach from health staff. Conversely, inconsistent goal terminology confuses patients and reduces engagement. Likewise, fatigue has profound physical and cognitive impact on patients' ability to engage and participate in goals.
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Affiliation(s)
- Nicky Baker
- Flinders University, Adelaide, South Australia, Australia
| | - Sharon Lawn
- Flinders University, Adelaide, South Australia, Australia
| | - Susan J Gordon
- Flinders University, Adelaide, South Australia, Australia
| | - Stacey George
- Flinders University, Adelaide, South Australia, Australia
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19
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Avgerinou C, Gardner B, Kharicha K, Frost R, Liljas A, Elaswarapu R, Manthorpe J, Drennan VM, Goodman C, Iliffe S, Walters K. Health promotion for mild frailty based on behaviour change: Perceptions of older people and service providers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1333-1343. [PMID: 31148312 PMCID: PMC6771617 DOI: 10.1111/hsc.12781] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 03/22/2019] [Accepted: 04/26/2019] [Indexed: 06/02/2023]
Abstract
Mild frailty is common among older people, but it is potentially reversible with health promotion interventions. Behaviour change may be a key to preventing progression of frailty; however, we know little about what interventions work best and how a behaviour change approach would be perceived by this group. The aim of this study was to explore how mildly frail older people perceive health promotion based on behaviour change and what factors affect engagement with this approach. We conducted semi-structured interviews with 16 older people with mild frailty who received a pilot home-based behaviour change health promotion service, including a dyad of older person/family carer, and two service providers delivering the service in two diverse areas of South England. Interviews were audio-recorded, transcribed and thematically analysed. The concept of goal setting was acceptable to most participants, though the process of goal setting needed time and consideration. Goals on maintaining independence, monitoring of progress and receiving feedback were reported to increase motivation. Physical/mental capability and knowledge/perception of own needs were main determinants of the type of goals chosen by participants as well as the approach used by the project workers. Older people with complex needs benefited from care coordination, with a combination of goal setting and elements of social, practical and emotional support in varying proportions. Mildly frail older people responded well to a behaviour change approach to promote health and well-being. Further consideration is needed of the most effective strategies based on complexity of needs, and how to overcome barriers among people with cognitive impairment.
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Affiliation(s)
- Christina Avgerinou
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
| | | | - Kalpa Kharicha
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
| | - Rachael Frost
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
| | - Ann Liljas
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
| | - Rekha Elaswarapu
- Age UK Ealing (Patient and Public Involvement and Engagement representative)LondonUK
| | - Jill Manthorpe
- Social Care Workforce Research UnitKing’s College LondonLondonUK
| | - Vari M. Drennan
- Centre for Health and Social Care ResearchKingston University and St George’s, University of LondonLondonUK
| | - Claire Goodman
- Centre for Research in Primary and Community CareUniversity of HertfordshireHatfieldUK
| | - Steve Iliffe
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
| | - Kate Walters
- Department of Primary Care and Population HealthUniversity College LondonLondonUK
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20
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Ploeg J, Valaitis RK, Cleghorn L, Yous ML, Gaber J, Agarwal G, Kastner M, Mangin D, Oliver D, Parascandalo F, Risdon C, Dolovich L. Perceptions of older adults in Ontario, Canada on the implementation and impact of a primary care programme, Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY): a descriptive qualitative study. BMJ Open 2019; 9:e026257. [PMID: 31201187 PMCID: PMC6575818 DOI: 10.1136/bmjopen-2018-026257] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES The aim of the study was to explore the perceptions of older adults on the implementation and impact of Health Teams Advancing Patient Experience: Strengthening Quality (Health TAPESTRY), a multicomponent primary care programme that seeks to improve care coordination for individuals through health-related goal-setting supported by trained lay volunteers who are an extension of an interprofessional team, and the use of technology to support communication among the team. DESIGN This study used a qualitative descriptive design. SETTING The setting for this study was two primary care practice sites located in a large urban area in Ontario, Canada. PARTICIPANTS The sample consisted of community-dwelling older adults aged 70 years and older. Participants were recruited from a convenience sample obtained from 360 clients who participated in the 12-month Health TAPESTRY randomised controlled trial. METHODS Semistructured interviews were conducted with 32 older adults either face-to-face or by telephone. Interviews were transcribed verbatim. Data were analysed using a constant comparative approach to develop themes. RESULTS Older adults' perceptions about the Health TAPESTRY programme included (1) the lack of a clear purpose and understanding of how information was shared among providers, (2) mixed positive and negative perceptions of goal-setting and provider follow-up after inhome visits by volunteers, (3) positive impacts such as satisfaction with the primary care team, and (4) the potential for the programme to become a regular programme and applied to other communities and groups. CONCLUSIONS Older adults living in the community may benefit from greater primary care support provided through enhanced team-based approaches. Programmes such as Health TAPESTRY facilitate opportunities for older adults to work with primary care providers to meet their self-identified needs. By exploring perceptions of clients, primary care programmes can be further refined and expanded for various populations.
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Affiliation(s)
- Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | | | - Laura Cleghorn
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marie-Lee Yous
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Jessica Gaber
- Department of Family Medicine, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gina Agarwal
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Monika Kastner
- Research and Innovation, North York General Hospital, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Dee Mangin
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Doug Oliver
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Fiona Parascandalo
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Cathy Risdon
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Dolovich
- Department of Family Medicine, McMaster University/McMaster Innovation Park, Hamilton, Ontario, Canada
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21
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Tourunen A, Siltanen S, Portegijs E, Eronen J, Rantanen T, Saajanaho M. Assimilative and Accommodative Coping and Older People's Leisure Activities. J Aging Health 2019; 32:778-786. [PMID: 31156014 DOI: 10.1177/0898264319852002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: Assimilative and accommodative coping strategies have hardly been studied in relation to leisure activities in old age. We investigated whether tenacious goal pursuit (TGP) and flexible goal adjustment (FGA) influence the association between physical performance and participation in leisure activities. Methods: A cross-sectional analysis was conducted among 187 community-dwelling people aged 79 to 93 years. TGP, FGA, and leisure activity participation were asked with questionnaires. Physical performance was assessed with the Short Physical Performance Battery (SPPB). Results: TGP moderated the relationship between physical performance and leisure activity participation. Despite low physical performance, people with high TGP had close to mean level of leisure activity participation, whereas low TGP was associated with very little activity. Most notably, people without high TGP had fewer outdoor activities and group activities outside home. Similar effects were not found for FGA. Discussion: Persistency, rather than flexibility, in goal pursuit appears to help older people be active in their leisure time.
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Affiliation(s)
- Anu Tourunen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Johanna Eronen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
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22
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Rantanen T, Pynnönen K, Saajanaho M, Siltanen S, Karavirta L, Kokko K, Karvonen A, Kauppinen M, Rantalainen T, Rantakokko M, Portegijs E, Hassandra M. Individualized counselling for active aging: protocol of a single-blinded, randomized controlled trial among older people (the AGNES intervention study). BMC Geriatr 2019; 19:5. [PMID: 30616537 PMCID: PMC6323746 DOI: 10.1186/s12877-018-1012-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 12/11/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Active aging has been established as a policy goal for aging societies. We define active aging at the individual level as striving for elements of well-being through activities in relation to a person's goals, functional capacities and opportunities. Increasing evidence suggests that any meaningful activity is beneficial for different aspects of well-being in older people. The aim of the present randomized controlled trial is to test the feasibility and effectiveness of a one-year community-based intervention on active aging. The AGNES intervention aims at increasing older peoples' participation in self-selected valued activities. METHODS The proposed study is a two-arm single-blinded randomized controlled trial. The intervention group receives individually tailored counselling for an active life (one face-to-face session, four phone calls and supportive written material) and the control group written general health information only. Two hundred older adults aged 75- and 80- year old, with intermediate mobility function and without cognitive impairment, living independently in the municipality of Jyväskylä, Finland, are recruited and randomized with a 1:1 allocation to the intervention and control group. Randomization is computer-generated stratified by sex and age. The primary outcome is active aging and secondary outcomes are well-being, depressive symptoms, quality of life, personal goals, mobility and physical activity. Measures are administered at pre-trial, mid-trial (at 6 months) and post-trial (12 months after baseline). DISCUSSION The AGNES intervention study will provide new knowledge on the effects of individualized counselling on active aging and the potential of older people to promote their own well-being. TRIAL REGISTRATION The trial is registered at ISRCTN - ISRCTN16172390 : Promoting well-being through active aging.
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Affiliation(s)
- Taina Rantanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Katja Pynnönen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Milla Saajanaho
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Sini Siltanen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Laura Karavirta
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Katja Kokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Anu Karvonen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Markku Kauppinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Timo Rantalainen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Merja Rantakokko
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Erja Portegijs
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
| | - Mary Hassandra
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, P.O. Box 35 (L335), 40014 Jyväskylä, Finland
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23
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Abstract
The anorexia of aging affects approximately a quarter of older people and is a major contributor to the development of under-nutrition and many other adverse health outcomes in older people. Despite the high prevalence, the anorexia of aging is frequently overlooked by clinicians and, of even more concern, it is commonly accepted as inevitable and a part of 'normal' aging. Early identification of risk coupled with efforts to mitigate these risks through appropriate interventions might stem the deleterious consequences of the anorexia of aging. This review aims to provide an update on the current knowledge base whilst making some practical suggestions that may be of use in clinical practice. Interventions such as exercise and good nutrition remain the preferred treatment while pharmacological options, whilst they continue to be trialed, are not currently recommended for routine clinical use.
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Affiliation(s)
- A D Jadczak
- Agathe Daria Jadczak, University of Adelaide, South Australia, Australia,
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24
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Environmental, Individual and Personal Goal Influences on Older Adults' Walking in the Helsinki Metropolitan Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 16:ijerph16010058. [PMID: 30587821 PMCID: PMC6339229 DOI: 10.3390/ijerph16010058] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 11/17/2022]
Abstract
Physical activity is a fundamental factor in healthy ageing, and the built environment has been linked to individual health outcomes. Understanding the linkages between older adult’s walking and the built environment are key to designing supportive environments for active ageing. However, the variety of different spatial scales of human mobility has been largely overlooked in the environmental health research. This study used an online participatory mapping method and a novel modelling of individual activity spaces to study the associations between both the environmental and the individual features and older adults’ walking in the environments where older adult’s actually move around. Study participants (n = 844) aged 55+ who live in Helsinki Metropolitan Area, Finland reported their everyday errand points on a map and indicated which transport mode they used and how frequently they accessed the places. Respondents walking trips were drawn from the data and the direct and indirect effects of the personal, psychological as well as environmental features on older adults walking were examined. Respondents marked on average, six everyday errand points and walked for transport an average of 20 km per month. Residential density and the density of walkways, public transit stops, intersections and recreational sports places were significantly and positively associated with older adult’s walking for transport. Transit stop density was found having the largest direct effect to older adults walking. Built environment had an independent effect on older adults walking regardless of individual demographic or psychological features. Education and personal goals related to physical activities had a direct positive, and income a direct negative, effect on walking. Gender and perceived health had an indirect effect on walking, which was realized through individuals’ physical activity goals.
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25
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Dunn M. Realizing and Maintaining Capabilities: Late Life as a Social Project. Hastings Cent Rep 2018; 48 Suppl 3:S25-S30. [PMID: 30311229 DOI: 10.1002/hast.909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
One central and unfortunately unavoidable characteristic of the aging process is its association with chronic physiological deterioration. Frailty, cognitive impairment, and physical conditions such as cardiovascular disease and vision and hearing loss are more frequent in this phase of life, and these conditions translate into an increasing need for care and support of multiple kinds. In traditional bioethical scholarship, these distinctive features of aging have been examined predominantly through a health-focused lens. My main contention in this essay, however, is that viewing aging within bioethics as primarily a health problem, to be addressed through frameworks for decision-making or for resource allocation, is inadequate. My aim is to consider how the health conditions associated with aging affect older people's lives in a much more expansive way than has typically been acknowledged. Just as importantly, I intend to show how shifting our bioethical imagination in this way raises different and challenging questions about what a good life in late life consists in and about what is owed to older people, in their personal and social lives, as a matter of justice.
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