Distribution and evaluation of sense of coherence among older immigrants before and after a health promotion intervention - results from the RCT study promoting aging migrants' capability

Interventions based on salutogenesis for older adults: An integrative review

AIMS

To synthesize the evidence of interventions based on salutogenesis for older adults.

BACKGROUND

With the increasing tendency of global ageing and the progression of 'healthy ageing', salutogenesis has been adopted as a framework of health promotion for older adults.

DESIGN

An integrative review following PRISMA guidelines.

DATA SOURCES

Seven databases including PubMed, Cochrane Library, Web of Science, Embase, Scopus, PsycINFO and CINAHL Plus were systematically searched on 29 September 2022 and updated on 18 July 2023.

RESULTS

Eighteen eligible studies were included in this review. Salutogenic-based interventions fell into three main categories: dialogue-based, health education courses based, and goal setting and achievement based. The intervention doses: length ranged from 4 weeks to 2 years, with most (n = 12) within 12 weeks; the duration of each session ranged from 30 to 150 min, with the majority (n = 7) within 1 h; the frequency ranged from five times weekly to three times in 10 months, and in six studies was once a week. Intervention providers were mostly multidisciplinary teams, while in four studies were nurses only. Most of the studies reported that salutogenic-based interventions could improve older adults' sense of coherence, quality of life, self-efficacy, self-management, meaning of life and mental health.

CONCLUSIONS

This review synthesized the interventions based on salutogenesis for older adults, including salutogenesis application, intervention and its doses, intervention settings and providers, and intervention effects. Future research on the effectiveness of the intervention, the optimal dose of the intervention and the underlying mechanisms are still necessary to understand salutogenic-based interventions.

NO PATIENT OR PUBLIC CONTRIBUTION

Not apply as it's a review paper.

RELEVANCE TO CLINICAL PRACTICE

Salutogenic-based intervention is effective for older adults in different scenarios to improve their health outcomes. Nurses play a key role in salutogenic-based interventional programs and thus should be essential personnel as the intervention provider.

The effectiveness of preventive home visits on resilience and health-related outcomes among community dwelling older adults: A systematic review

BACKGROUND

This research aimed to assess the effectiveness of preventive home visits (PHVs) in enhancing resilience and health-related outcomes among older adults living in the community.

METHODS

A comprehensive literature search was conducted in nine databases (PubMed, MEDLINE, CINAHL, Embase, Emcare, Web of Science (WOS), Scopus, PsycINFO and Cochrane Library. The search was undertaken between March 15 and 31, 2022 with subsequent updates performed on October 15, 2023 and April 10, 2024. This review also included grey literature sourced via Google, Google Scholar and backward citation searches.

RESULTS

Out of 5,621 records, 20 articles were found to meet the inclusion criteria with a total of 8,035 participants involved and the mean age ranged from 74.0 to 84.4 years. Using McMaster Critical Review Form for Quantitative Studies, we ascertained that the studies included in our analysis had moderate to high levels of quality. In addition to health-related outcomes, PHV interventions were also conducted to evaluate psychological effects (16 studies) and social outcomes (seven studies). Five studies conducted financial assessment to evaluate the costs of health and social care utilisation during PHV interventions. Regarding the results of the review, seven studies showed favourable outcomes, five indicated no effect and eight had equivocal findings. Only one study assessed resilience and determined that PHV had no effect on the resilience of the subjects.

CONCLUSION

This review found that the effectiveness of PHV interventions was uncertain and inconclusive. PHV interventions often prioritise health-related objectives. The incorporation of a holistic approach involving psychosocial health into PHV interventions is relatively uncommon. Due to the paucity of research on resilience as PHV outcome, we are unable to draw a conclusion on the effectiveness of PHV on resilience. Resilience should be prioritised as a psychological assessment in the future development of comprehensive PHV interventions, as it enables older adults to adapt, manage, and respond positively to adversities that may arise with age. Performing financial analysis such as costs and benefits analysis to incorporate the return on investment of PHV interventions is an added value for future research on this topic.

CLINICAL TRIAL REGISTRATION

PROSPERO registration number: CRD42022296919.

Prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries: A mixed method systematic review

BACKGROUND

Frailty is increasingly becoming a public health concern, especially among vulnerable populations. Older migrants from Low- and Middle-Income Countries to High Income Countries present with poorer health and are at increased risk of becoming frail. This review aims to explore the prevalence, perceptions, and experiences of frailty among older migrants from Low- and Middle-Income Countries to High Income Countries.

METHODS

This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Five electronic databases were comprehensively searched for relevant literature published from January 1, 2000, to April 30, 2023. Quality appraisal for the quantitative studies was done with the Joanna Brigg's critical appraisal tool for analytic cross-sectional studies, and the qualitative studies were assessed with the Critical Appraisal Skill Program tool for qualitative studies.

RESULT

Seven studies met the inclusion criteria. Frailty was assessed using modified versions of the Frailty Phenotype and Frailty Index. The prevalence of frailty using the Frailty Phenotype was 16.6 %, and 17 % to 61.9 % according to the Frailty Index. The perceptions and experiences of frailty were characterised by chronic ill-health and a review of healthy pre-migration and early migration lives.

CONCLUSION

Despite the variation in frailty assessment methods, the high prevalence of frailty among older migrants was highlighted across the included studies. The perceptions and experiences of frailty reflect a state of resignation which can complicate the state of frailty. There is the need for ongoing research among migrant groups to identify their predisposition to frailty for early intervention.

The Impact of Place of Residence on the Sense of Coherence of Population Aged 60–89: Evidence from Poland

Place of living is one of the most important socio-demographic factors which characterizes the lives of older people. The importance of with whom and under what conditions older adults live to a large extent determines their health and standard of living. The goal of the study was to find the relationship between the place of residence and housing condition of older adults in Poland and their sense of coherence and health problems. The 29-item Antonovsky SOC questionnaire was used. In the research 303 people (76% women and 24% men) aged 60–89 were evaluated: 158 lived in their own houses/flats, while 145 resided in Daily Homes of Social Assistance (DPS). The overall result for the sense of coherence was 129.65 for older adults living in their own homes and 126.48 for these living in DPS. Statistical dependence between the place of residence and sense of manageability and meaningfulness was found. There is no dependence between gender and the overall score, nor the three components of the sense of coherence. Statistical dependence was determined in the criterion of age. A higher level of meaningfulness was observed in people aged 60–74. Taking into account the place of residents, 52% of the respondents living in their own houses/flats experience loneliness and among the people living in Daily Homes of Social Assistance, 46% experience loneliness. The type of place of residence is one of the most important personal factors affecting the sense of coherence, chronic health problems, and sense of loneliness. The last factor, especially, can adversely affect community sustainability and undermine social cohesion.

Lifetime prevalence of polyvictimization among older adults in Sweden, associations with ill-heath, and the mediating effect of sense of coherence

Background

Experiences of violence and abuse is a prominent part of the life history of many older adults and is known to have negative health effects. However, the importance of multiple victimization over the life course, e.g., lifetime polyvictimization, is not well investigated in this age group. The objective of this study was to investigate the prevalence of lifetime physical, emotional, and sexual victimization as well as polyvictimization among older adults in Sweden. We explored background characteristics associated with polyvictimization and hypothesized that violence victimization and especially polyvictimization would be associated with lower health status. To better understand factors that promote health in the aftermath of victimization, we also explored the effect of two resilience factors, sense of coherence (SOC) and social support, on the association between victimization and ill-health.

Method

Cross-sectional data from a random population sample in Sweden (women n = 270, men n = 337) aged 60–85 was used. Respondents answered questions about exposure to violence, health status, social support, and SOC. Conditional process analysis was used to test if SOC mediates the association between victimization and health outcome, and if social support moderates the association.

Results

Overall, 24.8% of the women and 27.6% of the men reported some form of lifetime victimization and 82.1% of the female and 62.4% of the male victims were classified as polyvictims, i.e., reported experiences of more than one episode of violence. As hypothesized, we found a negative association between victimization and health status and the association was most prominent for polyvictims. We found moderated mediation for the association between polyvictimization and health status, i.e., polyvictimization was associated with lower SOC and SOC had a positive correlation with health status. Social support moderated the association, i.e., victims without social support had lower health scores.

Conclusions

Lifetime polyvictimization was common among older adults and associated with lower health status. To help victims of violence recover, or preferably never develop ill-health, a better understanding of what fosters resilience is warranted. This study implies that social support, and especially SOC may be factors to consider in future interventions concerning older adults subjected to violence.

Health-promoting and preventive interventions for community-dwelling older people published from inception to 2019: a scoping review to guide decision making in a Swedish municipality context

Background

Despite the promising evidence of health-promoting and preventive interventions for maintaining health among older people, not all interventions can be implemented due to limited resources. Due to the variation of content in the interventions and the breadth of outcomes used to evaluate effects in such interventions, comparisons are difficult and the choice of which interventions to implement is challenging. Therefore, more information, beyond effects, is needed to guide decision-makers. The aim of this review was to investigate, to what degree factors important for decision-making have been reported in the existing health-promoting and preventive interventions literature for community-dwelling older people in the Nordic countries.

Methods

This review was guided by the PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews), the methodological steps for scoping reviews described in the Arksey and O′Malley’s framework, and the Medical Research Council’s (MRC) guidance on complex interventions. Eligible studies for inclusion were randomised controlled trials (RCTs) concerning health promotion or primary prevention for community-dwelling older people implemented in the Nordic countries. Additionally, all included RCTs were searched for related papers that were reporting on additional factors. Eligible studies were searched in seven databases: PubMed, SCOPUS, CINAHL, Academic Search Elite, PsycINFO, SocINDEX, and SPORTDiscus.

Results

Eighty-two studies met the inclusion criteria (twenty-seven unique studies and fifty-five related studies). Twelve studies focused on fall prevention, eleven had a health-promoting approach, and four studies focused on preventing disability. All interventions, besides one, reported positive effects on at least one health outcome. Three studies reported data on cost-effectiveness, three on experiences of participants and two conducted feasibility studies. Only one intervention, reported information on all seven factors.

Conclusions

All identified studies on health-promoting and preventive interventions for older people evaluated in the Nordic countries report positive effects although the magnitude of effects and number of follow-ups differed substantially. Overall, there was a general lack of studies on feasibility, cost-effectiveness, and experiences of participants, thus, limiting the basis for decision making. Considering all reported factors, promising candidates to be recommended for implementation in a Nordic municipality context are ‘Senior meetings’, ‘preventive home visits’ and ‘exercise interventions’ on its own or combined with other components.

A systematic review on implementation of person-centered care interventions for older people in out-of-hospital settings

THE PURPOSE

of this study was to explore the content and essential components of implemented person-centered care in the out-of-hospital context for older people (65+).

METHOD

A systematic review was conducted, searching for published research in electronic databases: PubMed, CINAHL, Scopus, PsycInfo, Web of Science and Embase between 2017 and 2019. Original studies with both qualitative and quantitative methods were included and assessed according to the quality assessment tools EPHPP and CASP. The review was limited to studies published in English, Swedish, Danish, Norwegian and Spanish.

RESULTS

In total, 63 original articles were included from 1772 hits. The results of the final synthesis revealed the following four interrelated themes, which are crucial for implementing person-centered care: (1) Knowing and confirming the patient as a whole person; (2) Co-creating a tailored personal health plan; (3) Inter-professional teamwork and collaboration with and for the older person and his/her relatives; and (4) Building a person-centered foundation.

CONCLUSION

Approaching an interpersonal and inter-professional teamwork and consultation with focus on preventive and health promoting actions is a crucial prerequisite to co-create optimal health care practice with and for older people and their relatives in their unique context.

Developing and Evaluating an Educational Program for Respiratory Infection Prevention among Rural Elderly Residents in South Korea

Based on social cognitive theory (SCT), an educational program was developed to prevent rural elderly residents from respiratory infections in South Korea. The effectiveness of the program was investigated in terms of knowledge, attitudes, and practices about respiratory infection prevention, as well as social capital. A pretest–posttest nonequivalent control group quasi-experimental design was used to test the short-term effect of this program. In addition, 1- and 6-month follow-up surveys were administered to evaluate the long-term effects. A total of 69 subjects (37 in the experimental group and 32 in the control group) participated in the experiment. The results showed that knowledge about respiratory infection prevention, respiratory infection prevention practices, and social capital were enhanced among the elderly residents who participated in the educational program. The educational effects differed significantly across time periods (pretest, posttest, 1- and 6-month follow up) in all the above variables. In particular, the program remained effective 1 month after the intervention, but a reinforcement session extended the program’s effects up to 6 months later. This educational program would be used as an effective intervention to help rural elderly residents prevent respiratory infections.