A Qualitative Exploration of Choral Singing in Community-dwelling Older Adults

Spiritual care for older people living in the community: A scoping review

BACKGROUND

The population of older people should be supported to enjoy optimal quality of life. Health professionals should consider a range of interventions that support the older population to maintain their quality of life. One such interventional approach involves spiritual care.

OBJECTIVE

To explore what is known about spiritual care approaches for older people living in the community.

METHODS

Scoping review informed by Joanna Briggs Institute guidelines. Eight electronic databases were searched: CINAHL, Ageline, PubMed, ProQuest Nursing & Allied Health, PsycINFO, Scopus, Garuda, and Neliti. The review included quantitative and qualitative primary peer-reviewed research studies focusing on spiritual care interventions for older people living in the community published between 2011 and 2021 in English or Bahasa Indonesia. The search was uploaded into an electronic citation manager and imported into Covidence for screening.

RESULTS

A total of 29 studies were included in the review. While the studies were conducted in five continents, most were reported from the Asian continent. Five key issues based on the outcome of interventions were found namely psychological, physical, spiritual, multidisciplinary approach, and social connection.

CONCLUSION

This scoping review identifies spiritual interventions conducted across many countries have been implemented for older people living in the community. Although there are review limitations and further research is needed, these spiritual interventions, both faith-based and non-faith-based, are identified as useful to support the well-being of older people.

The art of aging well: a study of the relationship between recreational arts engagement, general health and mental wellbeing in cohort of Australian older adults

Introduction

Evidence of the benefits of arts engagement to community wellbeing has been mounting since the 1990s. However, large scale, quantitative, epidemiological studies of the "arts-healthy aging" relationship, or the types of arts older adults voluntarily choose to engage in as part of their everyday life, for enjoyment, entertainment or as a hobby (vs. therapy or interventions) are limited. The aims of this study were to describe older adult recreational arts engagement via the Busselton Healthy Ageing Study (BHAS) cohort, and to determine if there was an association between arts engagement, general health and mental wellbeing.

Methods

Overall, 2,843 older adults (born 1946-1964) from the BHAS cohort (n = 5,107) who had completed a supplementary arts survey (n = 3,055, 60%) and had data on required variables were included in this study (93% of those eligible). The dependent variable was general health (SF12) and subjective mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS). The independent variable was hours engaged in recreational arts in the last 12 months. A descriptive analysis followed by a linear regression analysis was conducted.

Results

The prevalence of recreational arts engagement in the last 12 months was 85% (mean = 132 h/year). Older adults engaged in the arts in a number of ways including attending events (79%), actively participating/making art (40%), as an arts society/club/organization member (20%), by learning about the arts (13%) or by volunteering/working in the arts (non-professional, 11%). When general health was assessed via the SF12, the average physical component score (PCS) was 50.1 (SD 8.9) and the average mental component score (MCS) was 53.6 (SD 8.3). When mental wellbeing was assessed, the average WEMWBS score was 54.9 (SD = 8.6). After adjustment for 12 demographic and lifestyle covariates, it was found that older adults who engaged in any recreational arts in the last 12 months had significantly higher WEMWBS scores and higher SF12 physical component scores than those who did not engage in the arts (0 h/year).

Discussion

Evidence of an arts-health relationship was found in this study. The suitability of the arts as a population based, healthy aging strategy to influence the mental wellbeing and general health of older adults should be investigated further.

Sing4Health: Randomised controlled trial of the effects of a singing group program on the subjective and social well-being of older adults

Group singing may be an optimal intervention strategy to promote active ageing and well-being; however, evidence with experimental validity is scarce. This study aims to fill this gap by analysing the effects of a 34-session singing group programme (SGP) on participants' subjective and social well-being and the mediating roles of social identification with the singing group and of self-esteem. An RCT with intervention (n = 89) and active waiting-list control (n = 60) conditions was conducted, and a mixed method quantitative and qualitative data collection and analysis were performed. Participants were mostly elderly day-care centre users (M = 76.66 years old; SD = 8.79) with low average levels of education and income. Structured measures of life satisfaction, positive and negative affect, self-esteem, loneliness, social identification and social well-being were collected, as well as interviews on the perceived benefits of participating in the SGP. Results showed significant effects of the SGP on the positive affect, social well-being and marginally on the self-esteem of the participants. The observed effects were sustained at the follow-up. Qualitative analysis corroborated the quantitative results. Mediation analysis showed indirect effects of social identification with the singing group on loneliness and social identification with the social care institution group; and of self-esteem on positive and negative affect.

A Study of the Experience of Working Adults on Regular Choral Activities: Applying Focus Groups

Maintaining a high quality of work and life can be a challenge for working adults. Most working adults do not have the opportunity to participate in activities that promote physical and emotional health. Working adults need to improve their potential to maintain life satisfaction and prevent a variety of stresses and physical illnesses. Recent research has suggested the effective value of art participation through choral activities for many people. However, little is known about what working adults experience through choir activities. In particular, research focusing on effects of choir participation on healthy people is lacking, and there is insufficient fundamental evidence about how to develop choral programs to improve the quality of healthy people’s lives. The purpose of this study was to explore the experience of working adults in the process of regularly participating in choral activities. Our research question is “What experiences did the participants gain from the choir activities?”. Data was collected in three focus group interviews and additional individual interviews with 15 participants. Four themes emerged from this study: “self-improvement and sense of accomplishment”, “interaction and harmony”, “discovery of positive self-identity”, and “healing and happiness”. These findings could encourage choir activity in working adults and suggest that they can be applied as lifelong activities that can improve their quality of life with social interaction.

Multi-cultural perspectives on group singing among diverse older adults

Group choir singing has been shown to have health benefits for older adults. However, because most studies have included predominantly white participants, it is unknown whether findings generalize to older adults from more diverse backgrounds. This multi-site qualitative study assessed perceived benefits of group singing for socioeconomically and racially/ethnically diverse older adults. We interviewed 31 choir participants, 6 music professionals and 6 administrators involved in a large, cluster-randomized trial. We used content analysis to identify themes. Psychosocial engagement was most commonly reported, with six components: emotional well-being, self-esteem, self-confidence, social connection and support, decreased loneliness, and cultural identity and multi-cultural appreciation. A few reported cognitive and physical benefits. They also suggest that group singing among ethnically diverse older adults can have multiple psychosocial benefits and enhance a sense of cultural identity and appreciation of other cultures. These findings can help in selecting structured outcome measures for choir interventions.

Predictors of change over time in subjective daytime sleepiness among older adult recipients of long-term services and supports

OBJECTIVES

Daytime sleepiness is associated with multiple negative outcomes in older adults receiving long-term services and supports (LTSS) including reduced cognitive performance, need for greater assistance with activities of daily living and decreased social engagement. The purpose of this study was to identify predictors of change in subjective daytime sleepiness among older adults during their first 2 years of receiving LTSS.

DESIGN AND SETTING

Secondary analysis of data from a prospective longitudinal study of older adults who received LTSS in their homes, assisted living communities or nursing homes interviewed at baseline and every 3 months for 24 months.

PARTICIPANTS

470 older adults (60 years and older) newly enrolled in LTSS (mean = 81, SD = 8.7; range 60-98; 71% women).

MEASUREMENTS

Subjective daytime sleepiness was assessed every 3 months through 2 years using the Epworth Sleepiness Scale. Multiple validated measures were used to capture health-related quality of life characteristics of enrollees and their environment, including symptom status (Symptom Bother Scale), cognition (Mini Mental Status Exam), physical function (Basic Activities of Daily Living), physical and mental general health, quality of life (Dementia Quality of Life, D-QoL), depressive symptoms (Geriatric Depression Scale) and social support (Medical Outcomes Survey-Social Support).

RESULTS

Longitudinal mixed effects modeling was used to examine the relationship between independent variables and continuous measure of daytime sleepiness. Increased feelings of belonging, subscale of the D-QoL (effect size = -0.006, 95% CI: -0.013 to -0.0001, p = 0.045) and higher number of depressive symptoms (effect size = -0.002, 95% CI: -0.004 to -0.001, p = 0.001) at baseline were associated with slower rates of increase in daytime sleepiness over time.

CONCLUSIONS

Comprehensive baseline and longitudinal screening for changes in daytime sleepiness along with depression and perceived quality of life should be used to inform interventions aimed at reducing daytime sleepiness among older adults receiving LTSS.