The Role of Meaning in Life for the Quality of Life of Community-Dwelling Chinese Elders With Low Socioeconomic Status

The Concerns of Community-Dwelling Older Women Living with Urinary Incontinence: Qualitative Research

INTRODUCTION AND HYPOTHESIS

The world including Iran is facing population aging. Urinary incontinence (UI) is one of the most common health concerns of older women that can be accompanied by an increased sense of loneliness, social restrictions, and disruption in activities of daily living in addition to the regular challenges of old age. This study was aimed at explaining the concerns of community-dwelling older women living with UI.

METHODS

This study used the conventional, qualitative, content analysis approach with purposive sampling. Twenty interviews were conducted with 18 participants, including 15 community-dwelling older women with UI and three family members (a husband and two daughters), over the span of 14 months (from August 2021 to October 2022). The data were collected via semi-structured, face-to-face interviews until data saturation was achieved, and were analyzed using Graneheim and Lundman's method.

RESULTS

The findings revealed that the concerns of older women with UI include the impasse of UI, being powerless in life, distorted social identity, and marital frustration, which fell under the main theme of sense of inadequacy.

CONCLUSIONS

Recognizing the concerns of older women with UI can make health care teams more sensitive to the importance of resolving these concerns and can offer some insight into how best to provide targeted training, support, and counseling services at individual, family, and society levels, to eventually resolve the older adult's sense of inadequacy.

Mediating effects of meaning in life on the relationship between family care, depression, and quality of life in Chinese older adults

Background

The study explored sources of meaning in older adults and the action path among family care, meaning in life, quality of life, and depression.

Materials and methods

We investigated 627 older adults using the Sources of Meaning in Life Scale for the Elderly (SMSE), the Family Care Index (APGAR), the Center for Epidemiological Studies Depression Scale-10 (CES-D-10), and the EuroqOL-5 Dimensions (EQ-5D).

Results

Scores categorized 454 older adults with good family function, 99 with moderate, and 47 with severe family dysfunction; 110 older adults had depression. The structural equation model showed that family care affected the quality of life and depression by influencing meaning, and depression had a significant negative effect on the quality of life (P < 0.05). The model was a good fit for the data (χ2/df = 3.300, SRMR = 0.0291, GFI = 0.975, IFI = 0.971, TLI = 0.952, CFI = 0.971, RMSEA = 0.062).

Conclusion

Meaning in life is an intermediary factor that affects depression and quality of life in older adults. Family care had a significant positive impact on SMSE and a negative influence on depression. The SMSE effectively clarifies the sources of meaning in life and can be used to improve meaning and promote mental health in older adults.

Association of meaning in life with preventive healthcare use among Chinese adults: are there age and gender differences?

BACKGROUND

Meaning in life could be of clinical importance in stimulating healthy and preventive behaviors. The study aimed to investigate the association between meaning in life and preventive healthcare use among Chinese adults, and to assess their age and gender differences in the association.

METHODS

A cross-sectional online survey was conducted among 1444 adults aged 18-64 years in February 2020 in China. Logistic regression models were employed to examine the association of meaning in life with preventive health checkups and assess their age and gender differences.

RESULTS

The mean score of meaning in life was 5.801 (Standard Deviation = 1.349) out of 7. Each unit increase on the level of meaning in life was associated with 12.2% higher likelihood of using preventive health checkups (any type) (adjusted odds ratio 1.122, 95% confidence interval 1.015-1.241) after adjustment for sociodemographic factors, comorbidity and other psychological health factors. Meaning in life was significantly associated with the uses of X-ray (1.125, 1.010-1.253), B-ultrasound (1.176, 1.058-1.306), and blood testing (1.152, 1.042-1.274). The associations between meaning in life and these types of preventive healthcare increased with age, but there were no gender differences in these associations.

CONCLUSION

Higher meaning in life was independently related to more preventive health checkups. Strategies to strengthen health education and interventions to improve experience of meaning in life might be an important component to increase preventive healthcare use in China.

Development of resilience scale for older adults

OBJECTIVES

Older adults are more likely to encounter adverse life events and have protective factors that are different from other populations. Currently, there is no resilience scale designed exclusively for older adults. This study aims at developing a new measurement scale for assessing resilience of older adults.

METHODS

Items of Resilience Scale for Older Adults (RSOA) was generated from thorough literature review. A multiple stage method was applied to examine the psychometric properties of the scale. In pretesting, items that did not meet the psychometric criteria were removed. A sample of 368 older adults was collected in the main survey to perform preliminary item selection and removal, reliability and construct validity analyses. Another survey on 76 samples was then conducted to assess test-retest reliability of the scale.

RESULTS

RSOA that comprised four constructs (personal strength, meaning and purpose of life, family support, and social support) with a total of 15 items was developed with good reliability and validity. Cronbach's α of the scale was 0.882. All the four constructs were found significantly correlated with life satisfaction of older adults.

CONCLUSIONS

The RSOA is a reliable means of assessing psychological and physical resilience of older people as well as predicting their satisfaction with life. The study may also provide important information about elderly coping with adversity.

Balance in life as a prerequisite for community-dwelling older adults' sense of health and well-being after retirement: an interview-based study

Purpose

This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement.

Methods

This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach.

Results

The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle.

Conclusions

The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.

The development of Need-Threat Internal Resiliency Theory in COVID-19 crisis utilizing deductive axiomatic approach

Resiliency for older people represents the capacity to return to equilibrium when difficulties arise and was found as integral predictor of their health status. This study aims to develop a theory that attempts to explain the older adults' resiliency perspectives during crisis and how it has affected their well-being and quality of life as population group. Deductive theory generation using axiomatic approach was adopted resulting to five axioms that served as basis for the generation of three propositions such as: (1) An older person's health needs have tendencies to develop into a health threat, (2) when the threat is perceived, older persons developed a sense of internal control and adaptation to the changes it creates known as internal resiliency, and (3) internal resiliency can influence the quality of life in old age. The evolved theory suggests that in times of crisis (e.g., COVID-19 pandemic), health needs develop into a health threat that compels older persons to develop internal resiliency in order to preserve their integrity, wellbeing and quality of life. This study widens the nursing perspectives in addressing older persons' resiliency by the unique condition at which older clients are placed affecting both the pathological nature of the illness as well as the preventive interventions which the society is forced to implement.

Lifestyle's influence on community-dwelling older adults' health: A mixed-methods study design

BACKGROUND

Aging often involves health problems and difficulties, such as physical and psychological impairments, isolation, and loneliness, causing social and existential consequences. Studies have explored aging from different perspectives. However, few studies have examined healthy older adults' genetic backgrounds, lifestyles, and meaning in life separately or in combination. This study aims to describe how healthy older adults experience aging, health, lifestyles, and meaning in life and explore potential genetic correlations.

METHODS AND DESIGN

The project will comprise three main parts: a quantitative section featuring the development and testing of a lifestyle questionnaire, a quantitative genetic analysis, and a qualitative interview study. Participants will be community-dwelling, healthy, older adults between 70 and 95 years of age. A sample size of 800 older adults will be invited to participate in seminars in collaboration with the national Swedish association Active Seniors. Data will be collected through lifestyle questionnaire, DNA extracted from saliva samples, and interviews. Based on questionnaire responses, profile groups will be created and compared statistically with variations in genetic backgrounds, providing the basis for recruiting participants to the qualitative interviews.

DISCUSSION

This study's expected outcome will be to gain knowledge about variations in genetic backgrounds correlated with individual experiences regarding aging, health, and meaning in life. This knowledge can improve the understanding of motivations for healthy lifestyle changes. The results can reveal potential implications for individual prerequisites to healthy aging and how health-promoting aging and lifestyle counseling can be adjusted to meet individual needs.

Care needs, social support and meaning in life in patients after acute heart failure hospitalisation: a longitudinal study

BACKGROUND

Meaning in life serves as a protective mechanism for coping with persistent, often distressful symptoms in patients with heart failure. However, meaning in life and its associated factors are not adequately explored in patients after acute hospitalisation for heart failure.

AIMS

To explore the associated factors of meaning in life in patients with heart failure from acute hospitalisation to 3 months post-discharge.

METHODS

A total of 103 hospitalised patients with heart failure in Northern Taiwan were recruited using a longitudinal study design and interviewed with structured questionnaires including meaning in life, symptom distress, care needs, and social support at hospitalisation, 1 month and 3 months post-discharge.

RESULTS

A total of 83 patients completed the 3 months follow-up. The presence of meaning in life significantly increased from hospitalisation to 3 months post-discharge. Decreases in care needs (B=-0.10, P=0.020) and social support (B=-0.18, P=0.016) from hospitalisation to 3 months post-discharge were significantly associated with an increase in the presence of meaning in life, while a decrease in social support was associated with an increase in the search for meaning in life (B=-0.17, P=0.034).

CONCLUSION

Care needs and social support were pivotal factors for developing meaning in life for patients with heart failure. Assessments of care needs and social support might help strengthen their meaning in life.

Correlation between Health-Related Quality of Life and Hand Grip Strength among Older Adults

Background: With advanced age, the progressive loss of muscle strength estimated by the handgrip strength (HGS) may result in a poorer health-related quality of life (HRQoL). Studying this association becomes a vital area of research for promoting aging-well. The aim of this study was to examine the correlation between HRQoL and HGS among community-dwelling older adults above 60 years old.Methods: Participants comprised of 176 older adults (mean age: 68.15 ± 6.74). The HGS was tested with Jamar® Dynamometer, and the EuroQuol-5 Dimensions 5Levels (EQ-5D-5L) questionnaire was used to assess HRQoL.Results: Both HGS and HRQoL were negatively correlated with age (p < .001). Lower values of HGS and HRQoL were recorded among older adults who had diagnosed with one or more chronic diseases (p < .001). Significant correlations were recorded between HGS and functioning, and subjective well-being domains of EQ-5D-5L. A relatively higher association was recorded between the functioning variables of EQ-5D-5L and HGS compared to subjective well- being variables.Conclusion: Handgrip strength is a simple and practical measure in identifying older adults at risk of physical decline. Maintaining handgrip strength may contribute to improving HRQoL, and can add an imperative dimension to promote aging-well in older adults ≥60 years old.