Summary: Successful Aging For The Geriatric Population
Critical Review of Quantitative Research
Successful Aging for the Geriatric Population
GizetteKhamphong
Washington Adventist University
NURS 370
Cheryl Robertson MSN CRNP-A
December 16, 2013
Successful Aging for the Geriatric Population
This review will compare and contrast two related nursing research papers: a cross-sectional descriptive quantitative study by Kozar-Westman et al.(2013), which examined the suitability of using the Successful Aging Inventory (SAI) to assess and describe components of successful aging in a specific population of older adults – those who reside in Assisted Living Communities (ALCs). A second a mixed-method study by Bell et al. (2011) investigated the effectiveness of utilizing …show more content…
a virtual Nintendo Wii game as a therapeutic resource for rehabilitation and enhancing quality of life of older adults residing in ALCs. CLINICAL RELEVANCE
In this era of technological advances in medicine, the population of adults 65 years or older who are living longer, with or without chronic illnesses, and who will require assistance with activities of daily living will markedly increase. It is not uncommon for seniors to experience stress and loss of independence when they are initially admitted to ALCs (Tracy and DeYoung, 2004). Identification of factors that contribute to psychological and physical well being for these individuals could result in a better understanding of how to formulate and design plans of care and therapeutic interventions to promote successful (and more autonomous) aging for this population going forward.
AUTHOR QUALIFICATIONS AND PROBLEM STATEMENT The three authors of the Kozar-Westman study all hold advanced nursing degrees – two PhDs and one Master’s (Kozar-Westman).
Troutman-Jordan is an Associate Professor at the School of Nursing at University of North Carolina, Charlotte, and Nies is Professor and Director of the School of Nursing at Idaho State University, Pocatello. In the Bell study, the primary author, Cynthia S. Bell, holds a PhD and OTR/L degree and is Assistant Professor at the Occupational Therapy for Winston-Salem State University, North Carolina. The second author, Elizabeth Fain, Ed.S, MHS, OTR/L, is an instructor at the Occupational Therapy Department at Winston-Salem State University. The remaining authors listed on the study are all students in occupational therapy at the same institution. The expected population growth of people 65 years or older in the US will inevitably result in an increasing number of individuals who will reside in ALC facilities to meet their basic needs pertaining to activities of daily living, including health and well being. Identification of the factors that constitute successful aging for this population, both from the standpoint of caregivers and from the perception of the constituent population, and possible therapeutic interventions to enhance quality of life, has been an important area of research that has been understudied and not adequately addressed, given the scope of the problem as it exists …show more content…
today.
CONCEPTUAL FRAMEWORK In the Kozer-Westman study, the authors’ conceptual definition of what constitutes successful aging for older individuals living in ALCs encompasses numerous factors: psychosocial dynamics, coping mechanisms, the ability of an individual to adapt to institutional living, and even an individual’s religious affiliation or concept of spirituality, among others. By contrast, the conceptual framework which informed the Bell study was that the use of interactive virtual games like the Nintendo Wii, which encourages physical activity using simulated real world scenarios, can provide a valuable psychosocial and physical rehabilitation tool for seniors living in ALCs by giving the participants a chance to lose themselves for a time in the virtual reality and focus on a task which affords the opportunity to increase self confidence and potentially even quality of life.
VARIABLES DEFINED The variables in the Kozer-Westman study were clearly defined: overall health, exercise routines, income, and acquired chronic illnesses in the study population. In the Bell study, the independent variables were quality of life, social relationships, and confidence in the ability to prevent falls, and the dependent variables were the CASP-19, SPA, and M-FES assessments.
LITERATURE REVIEW In the Kozer-Westman study, the authors used numerous resources for their literature review most of which validated their findings as a whole. The authors noted a dearth of previous studies which address the problem of successful aging in populations living in ALCs, and that none of the studies reviewed included a theoretical component. In addition, most of the studies cited served to substantiate the prevailing thinking that older adults who maintain health promoting practices such as regular exercise routines, and who are socially active and maintain a positive mental outlook are likely to age more successfully than those who don’t. The Bell study found that few studies have been published on the subject of virtual rehabilitation and recommended further research in this area to determine whether use of virtual interactive games like the Nintendo Wii can be valuable tools for rehabilitation in this patient population.
METHODS In the Kozer-Westman study, two hundred subjects 65 years or older, recruited from eight assisted living centers in North Carolina, participated in the study. The study was conducted within the setting of participants’ respective ALC communities. Participants were given informed consent requiring verbal acknowledgement prior to participation in the study. The measurement plan consisted of three steps. First, a screening tool called the Mini-Cog was used to determine the presence or absence of cognitive impairment in potential subjects. Those subjects who qualified for the study were then administered three instruments: the Successful Aging Inventory (SAI), Life Satisfaction Inventory (LSI-A), and Purpose in Life Test (PIL). The Centers for Epidemiologic Studies Depression Scale (CESD) was an additional metric added to assess depression related ineffectual coping mechanisms. Researchers also documented instances of any participant’s inability to complete the instruments used and took field notes on any difficulties experienced or comments exhibiting limited understanding of what was being asked. Each participant was also asked about their comfort level about completing the SAI. In the Bell study, twenty two subjects between the ages of 60 to 94 were enrolled in the study; twenty one of those completed the study. The instruments used included three assessments: Control, Autonomy, Self-realization, Pleasure-19 (CASP-19); the Social Provisions Scale (SPA) and the Modified Falls Efficacy Scale (M-FES). Warm-up exercises, Nintendo Wii bowling, and fall prevention education were the interventions.
ANALYSIS OF DATA In the Kozar-Westman study descriptive statistics were used to analyze characteristics of successful aging in the four scales: the SAI, LSI-A, PIL, and CESD, and the variability of each scale. Cronbach 's α was used to assess internal consistency and reliability of using the SAI in a population of ALC residents. Pearson’s coefficients were used to calculate relationships between scores on all four instruments. Calculations were made for correlations between each instrument in combination with each another. SPSS 17.0 was the statistical software used for data analysis. The Bell study utilized a repeated measures design of three different groups in their statistical analysis. TheWilcoxon Signed-Rank test was used to find differences in mean ranks for the repeated measures. The independent variables were quality of life, social relationships, and confidence in the ability to prevent falls, and the dependent variables were the CASP-19, SPA, and M-FES assessments.
REVIEW OF STUDIES
Results of the Kozar-Westman study were consistent with the literature in a number of categories. The authors found that regular exercise contributed to an enhanced level of successful aging for this population. Engagement in regular physical activity benefited these individuals not only on a physiological level, but also from a psychosocial standpoint.
Although the findings showed that only 20% of participants in the study described their aging as successful, these same participants tended to score high on SAIs and other measures of self-rated successful aging. The authors suggested that further examination of the associative meaning of what constitutes successful aging to these individuals is warranted. Finally, the authors recommend further follow up research to examine the effects of any interventions and strategies implemented to enhance quality of life for this population. Analysis of quantitative and qualitative data from the Bell study showed few significant items from which to draw conclusions. The authors recommend further studies investigating the potential psychosocial and physical benefits of using the Nintendo Wii game in ALCs.
SUMMARY OF PROFESSIONAL APPLICATION These studies both showed that identifying those factors that contribute to successful aging in older adults living in ALCs is not only critical for this growing population’s quality of life, but also significant from the perspective of health care institutions.
Programs designed to educate older adults in how to live healthier lifestyles promote self-autonomy and a greater level of well being for these individuals. New programs which utilize interactive virtual games need to be explored for their potential for rehabilitation and to enhance quality of life. Armed with the knowledge gained from these studies, health care providers may be better equipped to help those in assisted living communities achieve these goals. An independent, more autonomous, healthy older adult will require less hospitalization and less medical interventions, which will lessen the burden of healthcare costs for institutions and also at the national level. The nursing profession can potentially benefit from this research because the results can be utilized to design more efficacious and innovative care plans for the older adult population living in these communities going forward.
REFERENCES
Bell, C., et al. (2011). Effects of Nintendo Wii on Quality of Life, Social Relationships, and Confidence to Prevent Falls. Physical & Occupational Therapy In Geriatrics, 29(3), 213-221.
Howie, L., Troutman-Jordan, M., and Newman, A. M. (2014). Social Support and Successful Aging in Assisted Living Residents. Educational Gerontology, 40(1), 61-70.
Kozar-Westman, M., Troutman-Jordan, M., and Nies, M. A. (2013). Successful Aging Among Assisted Living Community Older Adults. Journal of Nursing Scholarships, 45(3), 238-246.
Tracy JP, and DeYoung S. (2004). Moving to an assisted living facility: exploring the transitional experience of elderly individuals. J Gerontol Nurs. 2004 Oct;30(10):26-33.
Successful Aging for the Geriatric Population
GizetteKhamphong
Washington Adventist University
NURS 370
Cheryl Robertson MSN CRNP-A
December 16, 2013
Successful Aging for the Geriatric Population
This review will compare and contrast two related nursing research papers: a cross-sectional descriptive quantitative study by Kozar-Westman et al.(2013), which examined the suitability of using the Successful Aging Inventory (SAI) to assess and describe components of successful aging in a specific population of older adults – those who reside in Assisted Living Communities (ALCs). A second a mixed-method study by Bell et al. (2011) investigated the effectiveness of utilizing …show more content…
a virtual Nintendo Wii game as a therapeutic resource for rehabilitation and enhancing quality of life of older adults residing in ALCs. CLINICAL RELEVANCE
In this era of technological advances in medicine, the population of adults 65 years or older who are living longer, with or without chronic illnesses, and who will require assistance with activities of daily living will markedly increase. It is not uncommon for seniors to experience stress and loss of independence when they are initially admitted to ALCs (Tracy and DeYoung, 2004). Identification of factors that contribute to psychological and physical well being for these individuals could result in a better understanding of how to formulate and design plans of care and therapeutic interventions to promote successful (and more autonomous) aging for this population going forward.
AUTHOR QUALIFICATIONS AND PROBLEM STATEMENT The three authors of the Kozar-Westman study all hold advanced nursing degrees – two PhDs and one Master’s (Kozar-Westman).
Troutman-Jordan is an Associate Professor at the School of Nursing at University of North Carolina, Charlotte, and Nies is Professor and Director of the School of Nursing at Idaho State University, Pocatello. In the Bell study, the primary author, Cynthia S. Bell, holds a PhD and OTR/L degree and is Assistant Professor at the Occupational Therapy for Winston-Salem State University, North Carolina. The second author, Elizabeth Fain, Ed.S, MHS, OTR/L, is an instructor at the Occupational Therapy Department at Winston-Salem State University. The remaining authors listed on the study are all students in occupational therapy at the same institution. The expected population growth of people 65 years or older in the US will inevitably result in an increasing number of individuals who will reside in ALC facilities to meet their basic needs pertaining to activities of daily living, including health and well being. Identification of the factors that constitute successful aging for this population, both from the standpoint of caregivers and from the perception of the constituent population, and possible therapeutic interventions to enhance quality of life, has been an important area of research that has been understudied and not adequately addressed, given the scope of the problem as it exists …show more content…
today.
CONCEPTUAL FRAMEWORK In the Kozer-Westman study, the authors’ conceptual definition of what constitutes successful aging for older individuals living in ALCs encompasses numerous factors: psychosocial dynamics, coping mechanisms, the ability of an individual to adapt to institutional living, and even an individual’s religious affiliation or concept of spirituality, among others. By contrast, the conceptual framework which informed the Bell study was that the use of interactive virtual games like the Nintendo Wii, which encourages physical activity using simulated real world scenarios, can provide a valuable psychosocial and physical rehabilitation tool for seniors living in ALCs by giving the participants a chance to lose themselves for a time in the virtual reality and focus on a task which affords the opportunity to increase self confidence and potentially even quality of life.
VARIABLES DEFINED The variables in the Kozer-Westman study were clearly defined: overall health, exercise routines, income, and acquired chronic illnesses in the study population. In the Bell study, the independent variables were quality of life, social relationships, and confidence in the ability to prevent falls, and the dependent variables were the CASP-19, SPA, and M-FES assessments.
LITERATURE REVIEW In the Kozer-Westman study, the authors used numerous resources for their literature review most of which validated their findings as a whole. The authors noted a dearth of previous studies which address the problem of successful aging in populations living in ALCs, and that none of the studies reviewed included a theoretical component. In addition, most of the studies cited served to substantiate the prevailing thinking that older adults who maintain health promoting practices such as regular exercise routines, and who are socially active and maintain a positive mental outlook are likely to age more successfully than those who don’t. The Bell study found that few studies have been published on the subject of virtual rehabilitation and recommended further research in this area to determine whether use of virtual interactive games like the Nintendo Wii can be valuable tools for rehabilitation in this patient population.
METHODS In the Kozer-Westman study, two hundred subjects 65 years or older, recruited from eight assisted living centers in North Carolina, participated in the study. The study was conducted within the setting of participants’ respective ALC communities. Participants were given informed consent requiring verbal acknowledgement prior to participation in the study. The measurement plan consisted of three steps. First, a screening tool called the Mini-Cog was used to determine the presence or absence of cognitive impairment in potential subjects. Those subjects who qualified for the study were then administered three instruments: the Successful Aging Inventory (SAI), Life Satisfaction Inventory (LSI-A), and Purpose in Life Test (PIL). The Centers for Epidemiologic Studies Depression Scale (CESD) was an additional metric added to assess depression related ineffectual coping mechanisms. Researchers also documented instances of any participant’s inability to complete the instruments used and took field notes on any difficulties experienced or comments exhibiting limited understanding of what was being asked. Each participant was also asked about their comfort level about completing the SAI. In the Bell study, twenty two subjects between the ages of 60 to 94 were enrolled in the study; twenty one of those completed the study. The instruments used included three assessments: Control, Autonomy, Self-realization, Pleasure-19 (CASP-19); the Social Provisions Scale (SPA) and the Modified Falls Efficacy Scale (M-FES). Warm-up exercises, Nintendo Wii bowling, and fall prevention education were the interventions.
ANALYSIS OF DATA In the Kozar-Westman study descriptive statistics were used to analyze characteristics of successful aging in the four scales: the SAI, LSI-A, PIL, and CESD, and the variability of each scale. Cronbach 's α was used to assess internal consistency and reliability of using the SAI in a population of ALC residents. Pearson’s coefficients were used to calculate relationships between scores on all four instruments. Calculations were made for correlations between each instrument in combination with each another. SPSS 17.0 was the statistical software used for data analysis. The Bell study utilized a repeated measures design of three different groups in their statistical analysis. TheWilcoxon Signed-Rank test was used to find differences in mean ranks for the repeated measures. The independent variables were quality of life, social relationships, and confidence in the ability to prevent falls, and the dependent variables were the CASP-19, SPA, and M-FES assessments.
REVIEW OF STUDIES
Results of the Kozar-Westman study were consistent with the literature in a number of categories. The authors found that regular exercise contributed to an enhanced level of successful aging for this population. Engagement in regular physical activity benefited these individuals not only on a physiological level, but also from a psychosocial standpoint.
Although the findings showed that only 20% of participants in the study described their aging as successful, these same participants tended to score high on SAIs and other measures of self-rated successful aging. The authors suggested that further examination of the associative meaning of what constitutes successful aging to these individuals is warranted. Finally, the authors recommend further follow up research to examine the effects of any interventions and strategies implemented to enhance quality of life for this population. Analysis of quantitative and qualitative data from the Bell study showed few significant items from which to draw conclusions. The authors recommend further studies investigating the potential psychosocial and physical benefits of using the Nintendo Wii game in ALCs.
SUMMARY OF PROFESSIONAL APPLICATION These studies both showed that identifying those factors that contribute to successful aging in older adults living in ALCs is not only critical for this growing population’s quality of life, but also significant from the perspective of health care institutions.
Programs designed to educate older adults in how to live healthier lifestyles promote self-autonomy and a greater level of well being for these individuals. New programs which utilize interactive virtual games need to be explored for their potential for rehabilitation and to enhance quality of life. Armed with the knowledge gained from these studies, health care providers may be better equipped to help those in assisted living communities achieve these goals. An independent, more autonomous, healthy older adult will require less hospitalization and less medical interventions, which will lessen the burden of healthcare costs for institutions and also at the national level. The nursing profession can potentially benefit from this research because the results can be utilized to design more efficacious and innovative care plans for the older adult population living in these communities going forward.
REFERENCES
Bell, C., et al. (2011). Effects of Nintendo Wii on Quality of Life, Social Relationships, and Confidence to Prevent Falls. Physical & Occupational Therapy In Geriatrics, 29(3), 213-221.
Howie, L., Troutman-Jordan, M., and Newman, A. M. (2014). Social Support and Successful Aging in Assisted Living Residents. Educational Gerontology, 40(1), 61-70.
Kozar-Westman, M., Troutman-Jordan, M., and Nies, M. A. (2013). Successful Aging Among Assisted Living Community Older Adults. Journal of Nursing Scholarships, 45(3), 238-246.
Tracy JP, and DeYoung S. (2004). Moving to an assisted living facility: exploring the transitional experience of elderly individuals. J Gerontol Nurs. 2004 Oct;30(10):26-33.