[Self-care: New evidence for its measurement in older adults]

Exploring personal aptitudes and personality traits that, together with social determinants, shape health behaviors and conduct: a thematic analysis based on the Capability, Opportunity, Motivation and Behavior (COM-B) change system

Introduction

Effective implementation of strategies to promote health and prevent noncommunicable illnesses requires a profound understanding of the interaction between the individual and society. This study brings to health research the consideration of psychosocial factors that influence the maintenance and change of health behaviors and conduct. From a primary care perspective, it is crucial to propose a biopsychosocial approach for the development of health promotion and self-care programs that embrace personal aptitudes as a relevant individual aspect.

Objectives

To explore experiences related to personal aptitudes and personality traits that influence health behaviors and conduct, taking into account the social determinants of health, through a thematic analysis based on the capability-opportunity-motivation and behavior (COM-B) system.

Methods and analysis

This qualitative research is carried out from a descriptive phenomenological perspective, based on 17 focus groups in which 156 people participated. Inductive and deductive analysis techniques were used following Lincoln and Guba's criteria of methodological rigor. In addition to 7 different triangulations of analysts, 6 main categories were identified based on the COM-B system: psychological capacity, physical capacity, physical opportunity, social opportunity, reflective motivation, and automatic motivation. The importance of considering these factors to promote healthy behaviors was stressed.

Discussion

This study examined how personal experiences related personal aptitudes and personality traits influence health behaviors and conduct in Spain. It was found that personality traits such as health literacy, self-efficacy, activation, and self-determination can influence the adoption of healthy behaviors. Likewise, the need for control, overthinking, and ambivalence made it impossible. Furthermore, social determinants of health and interpersonal relationships also play an important role.

Trial registration

ClinicalTrials.gov, NCT04386135. Registered on April 30, 2020.

Practices of Self-Care in Healthy Old Age: A Field Study

Two competing psychological approaches for how to care for oneself to stay healthy in old age have coexisted and dominated the scientific literature.

OBJECTIVE

Identify the self-care practices of healthy older adults and establish the relationship between these practices and the cognitive processes involved.

METHOD

105 healthy older people (83.91% women) recorded their self-care practices using the Care Time Test and underwent a cognitive evaluation.

RESULTS

The frequency and variety of different activities that participants spent performing on a day of the week where they had the fewest obligations are as follows: nearly 7 h on seven survival activities, 4 h and 30 min on three maintenance of functional independence activities and 1 h on one activity that promoted personal development. Older people who carry out activities in a developmental approach showed better everyday memory (8.63 points) and attention levels (7.00 points) than older people who carry out activities using a conservative approach (memory: 7.43; attention level: 6.40).

CONCLUSION

The results evidenced that the frequency and variety of activities that promote personal development are associated with better attention and memory performance.

Turkish Validity and Reliability of the Self-care of Hypertension Inventory (SC-HI) among Older Adults

PURPOSE

To assess the psychometric properties of the Turkish version of the Self-care of Hypertension Inventory (SC-HI) among older adults with hypertension.

DESIGN

This was a methodological study.

METHODS

The study sample enrolled 176 older adults. The study carried out preliminary psychometric analyses.

FINDINGS

Item-level content validity index ranged between 0.87 to 1.0, and the index of content validity was 0.98. The Cronbach's α for the total scale was 0.84.

CONCLUSION

The cross-cultural adaptation of SC-HI has been realized successfully in Turkish.

CLINICAL EVIDENCE

Health care providers may utilize the scale to evaluate "older individuals" hypertension self-care abilities.

Efecto de un plan de alta de enfermería para mejorar el autocuidado en los pacientes con falla cardiaca

Introducción: la falla cardiaca (FC) es una enfermedad de alto impacto en la calidad de vida de las personas. Por lo que es necesario el desarrollo de estrategias que promuevan el autocuidado desde la hospitalización y que apoyen el proceso de transición. Objetivo: determinar el efecto que tiene un plan de alta de enfermería en el nivel de autocuidado de los pacientes con FC que se encuentran hospitalizados de enero a noviembre de 2019. Metodología: ensayo clínico controlado con una muestra de 64 pacientes. Se aleatorizaron al plan de alta o al seguimiento usual. Para la medición del nivel de autocuidado se utilizó la escala europea de autocuidado con una alfa de Cronbach de 0,7. Se realizó un análisis descriptivo con tablas de frecuencias y de distribución porcentual y la prueba no paramétrica U de Mann Whitney. Resultados: antes de aplicar el plan de alta, se determinó que el 90,2 % de los pacientes del grupo control e intervención tenían un nivel bajo de autocuidado. Posterior a la aplicación del plan de alta se observó una mejoría estadísticamente significativa (p: 0,000) en el nivel de autocuidado. Conclusiones: el plan de alta tuvo un efecto beneficioso en el nivel de autocuidado gracias a sus componentes educativos, motivacionales, de refuerzo de conductas y gestión de síntomas. Este permitió que los pacientes asumieran un rol activo en la modificación de sus conductas para promover la salud.

Measurement of the will to live in older adults: Transcultural adaptation, validity and reliability of the Will-to-Live Scale

OBJECTIVE

The Will-to-Live Scale (WTLS) is used to measure the will to live in older adults; however, there is no Spanish version. The objective of the study was to translate the WTLS into Spanish, assess its internal structure, reliability, and the correlates between WTLS and life satisfaction, resilience, and depression in older Peruvian adults.

METHOD

The participants were 235 Peruvian older adults (M=72.69, SD=6.68), evaluated between March to May 2019, selected through non-probability sampling. The WTLS, the Satisfaction with Life Scale (SWLS), the Brief Resilient Coping Scale (BRCS) and the Patient Health Questionnaire-2 (PHQ-2) were administered. Data analysis included reliability by internal consistency and structural equation models, specifically confirmatory factor analysis (AFC), to test the one-dimensional solution of the WTLS and the convergent validity of the WTLS at the latent level, by specifying a four-factor model (will to live, life satisfaction, resilience and depression).

RESULTS

Cronbach's alpha coefficient and the composite reliability index obtain values of .93 and .94, respectively. The one-dimensional structure of the WTLS was fitted to the data (χ²₍₅₎=10,067, P=.073, CFI=.999, RMSEA=.066, SRMR=.014) and showed positive associations with the SWLS (ρ=.82), and BRCS (ρ=.86), as well as negative associations with the PHQ-2 (ρ=-.66).

CONCLUSION

The WTLS in Spanish presents evidence of validity and reliability to measure the will to live in Peruvian older adults.