Gail Low

Quality of life of older adults in Canada and Norway: Examining the Iowa model.

In this study, Glick and Tripp-Reimers (1996) Iowa model for gerontological nursing serves as a guiding framework for a descriptive exploratory study of quality of life (QOL) of older adults. Using secondary data, the authors explored whether the effects of health appraisal, morbidities, social support transitions (SST), and the environment on QOL would be partly mediated by cognitive developmental transitions (CDT). Data sets were available from studies with random samples of community-dwelling older adults from Canada (n = 202) and Norway (n = 490). The partly and fully mediated effects found suggest positive CDT in older age might be significantly enhanced by the presence of intimate ties, positive perceptions of ones health limitations, and residence in a healthy, safe, and resource-rich physical environment. These findings represent a novel attempt at testing complex linkages between aspects of elder, environment, and nursing concepts within the Iowa model warranting further research.

Linking Spiritual and Religious Coping With the Quality of Life of Community-Dwelling Older Adults and Nursing Home Residents:

Objective: This study examined the effect of Positive and Negative Spiritual and Religious Coping (SRC) upon older Brazilian’s quality of life (QOL). Method: A secondary analysis of data collected from 77 nursing home residents (NHRs; M age = 76.56) and 326 community-dwelling residents (CDRs; M age = 67.22 years) was conducted. Participants had completed the Brief SRC, and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and World Health Organization Quality of Life-OLD (WHOQOL-OLD). A General Linear Model regression analysis was undertaken to assess the effects of SRC upon 10 aspects of participants’ QOL. Results: Positive (F = 6.714, df = 10, p < .001) as opposed to Negative (F = 1.194, df = 10, p = .294) SRC was significantly associated with QOL. Positive SRC was more strongly associated with NHR’s physical, psychological, and environmental QOL, and their perceived sensory abilities, autonomy, and opportunities for intimacy. Conclusion: Positive SRC behaviors per se were significantly associated with QOL ratings across both study samples. The effect size of Positive SRC was much larger among NHRs across six aspects of QOL. Place of residence (POR) in relation to SRC and QOL in older age warrants further study.

Cultural Frames, Qualities of Life, and the Aging Self:

We used the Self-Concept Enhancement Tactician (SCENT) model to explore whether older Norwegians and Canadians would tactically self-enhance on qualities considered significant within their cultures in their self-perceptions of aging. Qualities were measured using the WHOQOL-BREF and WHOQOL-OLD. Self-perceptions of aging were measured by the Attitudes to Aging Questionnaire. The study is a secondary analysis of data collected in a larger study; 393 older Norwegians and 202 older Canadians were included. The Norwegian and Canadian group self-enhanced their perceptions of psychosocial loss based on harmonious social relationships and being part of a larger social group. For self-perceptions of physical change, both groups self-enhanced on being self-sufficient and being part of a larger social group. Our findings suggest that Norwegians and Canadians are not highly individualistic people and also provide evidence of a bicultural self-perception of aging. Nurses should consider how cultural and individual perspectives affect the care priorities of older people.

Perceptions About Self-Management Among People with Severe Asthma

Aim. The purpose of this study was to explore the perceptions about self-management among people who were being followed up in a severe asthma clinic by asthma specialists for confirmed, overall severe asthma. Such insight informs how best to tailor programs for this difficult to treat patient population. Method. In-depth tape-recorded interviews of eight adults with severe asthma were transcribed and analyzed for salient themes using content analysis. Results. To self-manage their illness, over time participants sought asthma information from a variety of sources that they often viewed as inadequate due to lack of scope and or plain language. The most valued sources of asthma information were encountered after referral to an asthma specialist and were health professionals and a pulmonary rehabilitation program. Conclusion. There is a need to examine the content of asthma information sources for their relevance to and influence on the behavior of patients with severe asthma.

Association of spiritual/religious coping with depressive symptoms in high‐ and low‐risk pregnant women

AIMS AND OBJECTIVES To investigate the role of spiritual/religious coping (SRC) on depressive symptoms in high- and low-risk pregnant women. BACKGROUND Spiritual/religious coping is associated with physical and mental health outcomes. However, only few studies investigated the role of these strategies during pregnancy and whether low- and high-risk pregnant women have different coping mechanisms. DESIGN This study is a cross-sectional comparative study. METHODS This study included a total of 160 pregnant women, 80 with low-risk pregnancy and 80 with high-risk pregnancy. The Beck Depression Inventory, the brief SRC scale and a structured questionnaire on sociodemographic and obstetric aspects were used. General linear model regression analysis was used to identify the factors associated with positive and negative SRC strategies in both groups of pregnant women. RESULTS Positive SRC use was high, whereas negative SRC use was low in both groups. Although we found no difference in SRC strategies between the two groups, negative SRC was associated with depression in women with high-risk pregnancy, but not in those with low-risk pregnancy. Furthermore, positive SRC was not associated with depressive symptoms in both groups. CONCLUSIONS Results showed that only the negative SRC strategies of Brazilian women with high-risk pregnancies were associated with worsened mental health outcomes. RELEVANCE TO CLINICAL PRACTICE Healthcare professionals, obstetricians and nurse midwives should focus on the use of negative SRC strategies in their pregnant patients.

Perspectives of aging among persons living with chronic obstructive pulmonary disease.

Among pulmonary rehabilitation attendees, we explored their tendency to downplay versus acknowledge physical and psychosocial health limitations, and the subsequent impact either strategy had on how they perceive their own aging process. Participants (N = 87) were 44 to 82 years of age, and diagnosed with chronic obstructive pulmonary disease (COPD). The St. George’s Respiratory Questionnaire measured their health limitations. The Attitudes to Aging Questionnaire captured their perspectives of aging. Participants downplayed their symptoms and psychosocial impact, and remained most positive about psychosocial loss and carefully reserved about psychological growth. Acknowledged activity impairment had negative consequences, however, for their perspectives of physical change. These findings signify a balanced identity and perspective of aging that supports the Identity Process Theory. We encourage nurses and other practitioners, and researchers in pulmonary rehabilitation setting, to use this theory to better understand how people with COPD adapt to aging.

Benefits of a self-help group for rural Thai elders with Type-2 Diabetes

บทคดยอ วตถประสงคของการวจยเชงปฏบตการแบบมสวนรวมในผสงอายไทยในชนบททเปนโรค เบาหวานชนดท 2 นเพอ: (1) ศกษาการรบรเกยวกบประสบการณการมสวนรวมในกลมชวยเหลอ ตนเองวาสงผลตอความสามารถดแลตนเองและคณภาพชวตอยางไรและ (2) เปรยบเทยบคะแนนความ สามารถดแลตนเอง คณภาพชวตและระดบนำตาลในเลอดกอนและหลงการมสวนรวมในกลมชวยเหลอ ตนเอง การวจยนไดแนวคดจากแผนพฒนาระบบสขภาพแหงชาต พ.ศ. 2550-2554 ทสงเสรมใหม การสำรวจความตองการและพฒนากลมชวยเหลอตนเองสำหรบผสงอายในชนบท ประกอบกบการท ผสงอายไทยในชนบททเปนโรคเบาหวานชนดท 2 ไดประสบกบภาวะแทรกซอนของโรคและอปสรรค หลายประการในการดแลตนเองอนกอใหเกดผลเสยตอสขภาพและคณภาพชวต ไดมการนำทฤษฎ วพากษสงคม (Critical Social Theory) มาเปนกรอบแนวคดสำหรบการทำวจย เกบขอมลจากการม สวนรวมในกลมชวยเหลอตนเองและแบบสอบถาม ผรวมวจย 20 คนถกคดเลอกจากรายชอผปวยท เปนโรคเบาหวานชนดท 2 ทขนทะเบยนผปวยไวทสถานอนามยของหมบานหนงในจงหวดหนงของภาคกลาง ผรวมวจยไดเขารวมกลมชวยเหลอตนเองทกสองสปดาหเปนเวลา 6 เดอน ขอมลเชงคณภาพจาก การประชมกลมและการสงเกตถกนำมาวเคราะหเชงเนอหา ขอมลเชงปรมาณอนประกอบดวยระดบ นำตาลในเลอด แบบสอบถามเกยวกบความสามารถดแลตนเองและคณภาพชวตทงกอนและหลงเขา รวมกลมชวยเหลอตนเองไดนำมาวเคราะหหาคาความแตกตางดวยสถต paired-samples t test จากการเขากลมชวยเหลอตนเองพบประโยชนทผรวมวจยไดรบ 4 ดานคอ ความรทสอดคลอง กบวฒนธรรมทองถน (culturally-sensitive knowledge) การชวยเหลอทางสงคม ความมพลงอำนาจ และการรบรความสามารถตนเอง (self-efficacy) ผลการวจยแสดงใหเหนวาการรบรความสามารถตนเอง ไดสงเสรมใหผรวมวจยมกจกรรมการดแลตนเองเมอเปนโรคเบาหวานชนดท 2 มากขน นอกจากนพบ วาการเขากลมชวยเหลอตนเองทำใหผรวมวจยมคะแนนความสามารถดแลตนเองและคณภาพชวตเพม ขนและมระดบนำตาลในเลอดกอนรบประทานอาหารเชาลดลง กลมชวยเหลอตนเองนบวาเปนประโยชน อยางยงสำหรบการสงเสรมสขภาพผสงอายไทยในชนบททเปนโรคเบาหวานชนดทสอง คำสำคญ : โรคเบาหวานชนดท 2, คณภาพชวต, ความสามารถดแลตนเอง, กลมชวยเหลอตนเอง, ระดบนำตาลในเลอด Abstract The objectives of this participatory action research, with rural Thai elders with type-2 diabetes, were to: (a) explore perspectives of the elders with respect to how taking part in a self-help group on diabetes affected their self-care ability and quality of life; and, (b) compare self-efficacy and quality of life scores, and blood glucose levels, of the elders, before and after participation in a self-help group on diabetes. The research was undertaken in light of the fact that: Thailand’s 2007-2011 national health plan promotes identification of needs for, and development of, community self-help groups for rural elders; and, rural Thai elders, with type-2 diabetes, face multiple self-care barriers and complications, which put them at risk for poor health and decreased quality of life. Critical Social Theory was used as the guiding framework for the study. Data were gathered through use of a self-help group and questionnaires. Twenty participants were selected, from a database of elders with type-2 diabetes, who were registered at the community health care center of a rural village, in central Thailand. Participants took part in the self-help group, every other week, for 6 months. Qualitative data, from the self-help group meetings and observations, were analyzed via content analysis. Quantitative data, including fasting blood sugar levels and data from questionnaires assessing the elders’ self-efficacy and quality of life, obtained prior to and after completion of the self-help group, were analyzed through use of paired-samples t-test. Upon completion of the self-help group, four themes emerged from the qualitative data. The themes included: obtained culturally-sensitive knowledge; perceived social support; perceived sense of empowerment; and, perceived self-efficacy. The results revealed positive self-efficacy enabled participants to improve their self-care activities. In addition, the quantitative data suggested participants, after completion of the self-help group, had higher self-efficacy and quality of life scores, as well as lower fasting blood sugar levels. Thus, the use of a community-based self-help group appeared to be an effective health promotion strategy for rural Thai elders with type-2 diabetes. Keywords : Type-2 Diabetes, Quality of life, Self-efficacy, Self-help group, Blood glucose levels

Lifelong Health and Health Services Use: A New Focus for Gerontological Nursing Research and Practice

It is commonly believed that older adults are often ill and therefore high users of health services. A pilot study involving adults 60 and older living in the Canadian province of Alberta was conducted to (a) raise interest in the concepts of lifelong health and health services use; (b) develop a lifelong health data collection tool; (c) obtain information about lifelong and recent health services use, and self-perceived lifelong and current health; and (d) reveal links (if any) between perceived health and lifelong health services use. A questionnaire was developed, pilot tested, and posted for completion by 100 volunteers. Most older adults reported good or very good current and lifelong health. Comorbidities and low finances were associated with higher health services use. These findings suggest community-dwelling older adults may be healthy currently and throughout their lives. Gerontological nursing research, practice, and advocacy are needed because myths about aging must be addressed to refocus attention on the importance of lifelong health promotion for older adults. [Journal of Gerontological Nursing, 43(2), 28-32.].

A Critical Review of Published Research Literature Reviews on Nursing and Healthcare Ageism

AIMS AND OBJECTIVES To establish how common and impactful nursing and healthcare ageism is and whether proven interventions or prevention methods exist. BACKGROUND Ageism has been a concern since 1969 when it was first introduced as a concept for social reform. As ageism has been linked to lower quality health services and reduced health care access, it is imperative that healthcare and nursing ageism is prevented or identified and reduced or eliminated. DESIGN A qualitative narrative review of published research literature reviews using a scoping design to map all published reviews was undertaken. The EBSCO Discovery Service (providing access to articles in 271 databases, including MEDLINE and CINAHL) and Directory of Open Access Journals (providing access to over 9,000 open access journals) were used to find review articles. Using predetermined inclusion and exclusion criteria, and limited by English language and peer-review publications, 12 eligible reviews were identified and information from them was systematically identified, assessed and synthesised. RESULTS The 12 reviews did not provide clear and convincing information to determine how common and impactful nursing or healthcare ageism is, nor what can best be done to prevent or address it. Although each review had value since research literature was collected and discussed on nursing or healthcare ageism, the array of literature search and analysis methods, and diversity in conclusions reached about the evidence is highly problematic. CONCLUSION Research literature reviews offering a more balanced perspective and demonstrating greater care in finding and using quality evidence are needed. RELEVANCE TO CLINICAL PRACTICE At this point in time, there is no clear understanding of how widespread and impactful nursing or healthcare ageism is, and what can best be done to prevent or address it. Nurses need to be aware that ageism may be common and impactful, and guard against it.

Identity Processes Among Older Norwegians Living in Urban and Rural Areas

Guided by the Identity Process Theory, we examined whether 424 Norwegians 60+ years of age would attribute their physical and mental functioning to their health (identity assimilation), to aging itself (identity accommodation), or to both (identity balance). We were also interested in the effect of these attribution styles upon depressive symptoms. Secondary data from the 2004 World Health Organization Quality of Life OLD Group Norwegian Field Study were analyzed using General Linear Model Regression and subsequent Path Analyses. Attributing physical functioning to health as opposed to aging had a negligible effect on depressive symptoms among both study groups. Attributing mental functioning to aging worsened depressive symptoms among rural participants. Attributing mental functioning to health was associated with more positive perceptions of psychosocial loss among urban participants. Positivity toward psychosocial loss lessened depressive symptoms and factors affecting those perceptions differed among rural versus urban participants. Adapting to functional changes in older age is a complex process affecting depressive symptoms.