Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 33, blok J, PB 7001, 3000, Leuven, Belgium.
CEBAM Belgian Centre for Evidence-based Medicine vzw, Kapucijnenvoer 33, blok J, PB 7001, 3000, Leuven, Belgium.
BMC Geriatr. 2021 Jul 9;21(1):418. doi: 10.1186/s12877-021-02365-w.
Problems with mobility, functioning and social participation make living independently difficult for frail older adults. To continue living independently, therapy adherence is a prerequisite. The causes for non-adherence among older adults are multiple and complex, which is why insight into older adults' perspectives regarding their functioning is an essential factor to increase therapy adherence. This study investigates the perspectives of older adults on their functioning, social participation and health, and the factors influencing these elements.
We conducted a qualitative study on the older adult's perceived functioning, social participation and health. Fourteen home-dwelling older adults suffering from chronic health issues were purposively selected. Semi-structured interviews were conducted with open-ended questions. Data were analysed following the Basic Logical Model of Abduction and Creswell's coding method.
Assistive devices, the older adult's dwelling and living environment, professional and informal support, and medication are perceived as important determinants for retaining functioning and social participation. Attitude, social influence and personal effectiveness were found to influence whether a person performs or participates in an activity. A person's attitude is related to the significance the activity has to that person, the activity's importance, personal wellbeing, the person's values, and their desire for autonomy. Peers and children have a social influence on the level of activity of the older person. Traditions, in particular religious activities, along with personal effectiveness are motivating factors determining whether a person performs or participates in an activity. Personal effectiveness is linked to the person's belief in their personal competencies and to the relationship between effort and result. Finally, it appears that the type of coping strategy the older adult adopts, has an influence on their behavior. The participating older adults often used remarkable problem-focused strategies, which had a positive effect on their level of autonomy.
Older adults have identified barriers and facilitators that influence their level of functioning and social participation. These findings help to create a framework for maintaining and increasing therapy adherence, which may be helpful in facilitating occupational therapists and other healthcare professionals to detect determinants of therapy adherence.
行动能力、功能和社会参与方面的问题使体弱的老年人难以独立生活。为了继续独立生活，坚持治疗是一个先决条件。老年人不坚持治疗的原因有很多且复杂，这就是为什么了解老年人对其功能的看法是提高治疗依从性的一个重要因素。本研究调查了老年人对其功能、社会参与和健康的看法，以及影响这些因素的因素。
我们对老年人的感知功能、社会参与和健康进行了定性研究。有目的选择了 14 名患有慢性健康问题的居家老年人。采用开放式问题进行半结构式访谈。根据溯因的基本逻辑模型和克雷斯韦尔的编码方法对数据进行分析。
辅助器具、老年人的住所和生活环境、专业和非正式支持以及药物被认为是维持功能和社会参与的重要决定因素。态度、社会影响和个人效能被发现会影响一个人是否执行或参与某项活动。一个人的态度与该活动对该人、活动的重要性、个人幸福感、个人价值观以及他们对自主权的渴望有关。同龄人及子女对老年人的活动水平有社会影响。传统，特别是宗教活动，以及个人效能是决定一个人是否执行或参与某项活动的激励因素。个人效能与个人对自身能力的信念以及努力与结果之间的关系有关。最后，似乎老年人采用的应对策略类型对他们的行为有影响。参与研究的老年人经常使用显著的问题聚焦策略，这对他们的自主水平有积极影响。
老年人已经确定了影响其功能和社会参与水平的障碍和促进因素。这些发现有助于建立一个维持和增加治疗依从性的框架，这可能有助于促进职业治疗师和其他医疗保健专业人员发现治疗依从性的决定因素。
