A new look at successful aging : exploring a mid-range nursing theory among older adults in a low-income retirement community.

The current view of successful aging excludes elders with disease or disability, limits the potential for success among disadvantaged populations, and fails to consider older adults’ own criteria for success, especially in the existential or spiritual domain. This cross-sectional study was a preliminary investigation of a mid-range nursing theory (Flood, 2005) of successful aging. A random, stratified sample (N= 112) was used. Questionnaires were administered to small groups of non-demented older adults. Relationships among study variables were examined using hierarchical multiple regression. Adaptation and transcendence explained 45.4% of the variance in successful aging, independent of age, income, function, and health. Transcendence accounted for 2.5 times the effect of adaptation

Exploring a new theory of successful aging among low-income older adults in an independent and assisted living community.

BACKGROUND: Current successful aging theory excludes individuals with disease or disability, limits the potential for successful aging in minority and lower socioeconomic populations, focuses on behavioral determinants of health rather than social and environmental determinants, and fails to consider older adults\u27 own criteria for successful aging. A recent mid-range nursing theory (Flood, 2005) proposed that two factors - adaptation and gerotranscendence - are primary contributors to a new view of successful aging that may address these problems. PURPOSE: The goal of the study was to investigate relationships among adaptation, transcendence, and successful aging to explore the potential of Flood\u27s (2005) theory to serve as a guide to nursing research, practice, and policy. METHODS: A cross-sectional survey study was conducted among a stratified, random sample (N= 112) of non-demented older adults living independently or receiving assisted living services in an urban low-income continuing care retirement community. Investigator administered surveys were conducted with small groups (n= 5 to 7). Recruitment minimized the number of surveys subsequently excluded due to dementia (6.4%). Data collection, including consent, dementia screening, and administration of surveys was completed in a single session, while preserving participants\u27 privacy and dignity. Efforts were made to accommodate sensory or literacy limitations. RESULTS: The study found significant support for Flood\u27s (2005) theory of successful aging. Adaptation and transcendence explained 45.4% of the variance in successful aging, controlling for age, income, function, and health. Transcendence accounted for two-and-a-half times the effect of adaptation. Ninety-two percent of participants reported they were aging successfully, regardless of age, health, function, income, or objective measures of successful aging. The study also supported the use of the newly developed Successful Aging Inventory (Flood, 2008) as an outcome measure to capture the new definition of successful aging (alpha .82). CONCLUSIONS: Flood\u27s theory of successful aging appears to merit further study of its potential to address the needs of older adults with disease, disability or socioeconomic disadvantages. Transcendence may be an important contributor to a holistic, positive view of aging that has not been previously reported in the successful aging literature

Multisite recruitment and data collection among older adults : exploring methods to conserve human and financial resources.

The purpose of this article is to describe strategies that were effective in recruitment and data collection among older adults in 3 quantitative studies while decreasing costs in terms of time and money. Factors effective in reducing use of investigators\u27 time and expenses included limiting exclusion of data because of abnormal Mini-Cog scores by careful initial screening and avoiding repeated reminders or follow-up, collecting data in small groups, collapsing consent, dementia screening, and data collection into single sessions, as well as accommodating for sensory and literacy deficits. The cross-sectional, descriptive studies were conducted among community-dwelling older adults attending senior citizen centers and among older adults in independent or assisted living apartments within continuing care retirement communities (CCRCs). 1 In the latest study, a convenience sample (N = 152) was recruited and data collection was completed in 4 weeks at a total cost of less than $5,000. Methods common to qualitative research and those commonly used in community-based research were adapted to reduce time and costs for recruitment, screening, and data collection. Given limited availability of research funding, other nursing researchers may find one or more of these methods useful

The role of transcendence in a holistic view of successful aging : a concept analysis and model of transcendence in maturation and aging.

BACKGROUND: Although successful aging is most often defined by the absence of disease and disability, older adults consistently report aging successfully even in the presence of chronic illness and functional limitations. A more holistic way of looking at old age suggests transcendence may be an important missing criterion for successful aging. AIM: Transcendence, a late life developmental process, appears to have a profound effect within the spiritual domain, but is an abstract, complex and unfamiliar concept. A clear understanding of the meaning of transcendence is necessary to explore the concept’s usefulness as a potential basis for future interventions to increase successful aging. METHODS: Walker and Avant’s (2004) method of concept analysis was adapted to analyze literature from philosophy, theology, developmental psychology, sociology, psychiatry and nursing to gain a thorough understanding of transcendence. RESULTS: Antecedents, attributes, referents and consequences of transcendence were identified then displayed in a conceptual model. A definition of transcendence in relation to successful aging was synthesized from the analysis. CONCLUSION: The concept analysis suggested transcendence may provide a theoretical foundation for development of potentially cost-effective, efficacious interventions to foster a sense of meaning in life, well-being, and life satisfaction. The model under development may prove useful in planning potential interventions

A multidisciplinary concept analysis of empowerment : implications for nursing.

According to the Institute of Medicine, nursing has failed to effectively shape the health care system and to advocate successfully for patients. Empowerment may be a potent tool to fulfill these responsibilities, yet nurses have not benefited from considering application of the concept to the continuum of health care advocacy in their communities, in their relationships with clients, and in their professional roles within health care organizations. This paper uses concept analysis to examine the attributes, characteristics, and uses of empowerment within diverse disciplines to clarify its meaning and explore its potential application to nursing\u27s challenges that cross settings, disciplines, and time

Successful aging in the United States and China : a theoretical basis to guide nursing research, practice, and policy.

Successful aging is an idea gaining increasing attention given the exponential growth in the older adult population. Criteria and definitions within multiple disciplines vary greatly in Western literature, with no consensus on its meaning. Moreover, sociocultural, economic and political differences between the Western view of successful aging and its use in China – with the world’s largest older adult population – add to the confusion. Similarities and differences in the meaning of successful aging in the United States and China are examined and the potential for a common definition that is useful to nursing in both countries is explored. Using the process of concept analysis, shared criteria for successful aging were: decreased or delayed incidence of disease and disability, life satisfaction, a sense of meaning and purpose in life, and the ability to cope effectively to achieve goals based on personal values and priorities. A comprehensive, multidimensional definition of successful aging for nursing, and a mid-range nursing theory of Theory of Successful Aging, were identified and may be useful to guide nursing research, practice and development of aging policy and programs

Assessing the Psychoeducational Approach to Transcendence and Health (PATH) program : an intervention to foster self-transcendence and well-being in community-dwelling older adults.

The late-life developmental process of self-transcendence shapes elders’ perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators’ and participants’ experiences and perceptions, the intervention will be revised and strengthened

The role of self-transcendence : a missing variable in the pursuit of successful aging?

While successful aging is often defined as the absence of disease and disability or as life satisfaction, self-transcendence may also play an important role. The objective of this research was to test a nursing theory of successful aging proposing that transcendence and adaptation predict successful aging. In this cross-sectional exploratory study, a convenience sample of older adults (N = 152) were surveyed about self-transcendence, proactive coping, and successful aging. Using hierarchical multiple regression, self-transcendence, proactive coping, and all control variables (i.e., sex, race, perceived health, place of residence) together explained 50% of the variance in successful aging (p \u3c 0.001). However, proactive coping alone was not a significant predictor of successful aging. Thus, this study did not support the theory that both self-transcendence and proactive coping predict successful aging. Self-transcendence was the only significant contributor to this multidimensional view of successful aging. Self-transcendence is an important variable in the pursuit of successful aging, which merits further investigation

Promoting self-transcendence and well-being in community-dwelling older adults : a pilot study of a psychoeducational intervention.

Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being of older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility study supports further investigation to assess the effectiveness of the intervention in a larger sample

Facilitating Self-Transcendence: An Intervention to Enhance Well-Being in Late Life

This randomized controlled pilot study evaluated the effects of the Psychoeducational Approach to Transcendence and Health (PATH) Program, an 8-week intervention hypothesized to increase self-transcendence and improve well-being in community-dwelling women aged 60 years and older (N = 20). The PATH combined mindfulness exercises, group processes, creative activities, and at-home practice using community engaged research methods. Findings provided some support for the effectiveness of PATH. Although there was no significant Group × Time interaction, self-transcendence, psychological well-being, and life satisfaction differed significantly pre- and postintervention in the wait-listed control group, which received a revised version of the program. Further study is needed with a larger sample to determine the effectiveness of PATH. Potentially, PATH may be a convenient and affordable activity to support personal development and improve well-being among older adults at senior centers, retirement communities, nursing homes, church groups, and other places where older adults gather