Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
NIHR Applied Research Collaboration South West Peninsula, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK.
Gerontologist. 2024 Feb 1;64(2). doi: 10.1093/geront/gnad073.
Understanding how older people experience independence has implications for person-centered care. Existing understanding of older people's experience of independence, generated through methods that provide a "snapshot" view of a person's independence at a given time point, provides little insight into the process of maintaining independence through time. The aim of this study was to explore older participants' perceptions to understand the processes and resources that were most important for maintaining independence.
Two semistructured interviews were conducted longitudinally to explore the perspectives of 12 community-dwelling, older people, aged 76-85 years. A social constructivist approach, using dramaturgical and descriptive codes, facilitated the interpretation of the data. Sixteen analytical questions guided the exploration of participants' perceptions of independence through time.
Older people suggested that objective representations underestimated, and omitted, important aspects of their independence through time. Some participants perceived "snapshot" judgments of their independence as insensitive to their individual values and context. Change over time required some participants to adapt their methods for maintaining independence. The stability of participants' sense of independence was value dependent and informed by the purpose a participant ascribed to maintaining independence.
This study augments the understanding of independence as a complex and multifaceted construct. The findings challenge the congruence of common interpretations of independence with older people's views, showing areas of commonality, and discrepancy. Exploration of independence in terms of form and function provides an important understanding of how function takes precedence to form in determining the maintenance of independence through time.
理解老年人如何体验独立性对以患者为中心的护理具有重要意义。现有关于老年人独立性体验的理解是通过在特定时间点提供个人独立性“快照”的方法得出的，这些方法几乎无法深入了解随着时间推移维持独立性的过程。本研究旨在探索老年人的认知，以了解对维持独立性最重要的过程和资源。
通过两次半结构化访谈，从纵向角度探讨了 12 名居住在社区的、年龄在 76-85 岁的老年人的观点。采用社会建构主义方法，使用戏剧性和描述性代码，有助于解释数据。16 个分析问题指导了对参与者随着时间推移对独立性的认知的探索。
老年人认为客观表现低估了，并且忽略了他们随着时间推移的独立性的重要方面。一些参与者认为对他们独立性的“快照”判断对他们的个人价值观和背景不敏感。随着时间的变化，一些参与者需要调整他们维持独立性的方法。参与者对独立性的稳定性取决于其个人价值观念，并受到参与者赋予维持独立性的目的的影响。
本研究增强了对独立性作为一个复杂和多方面的概念的理解。研究结果挑战了人们对独立性的常见解释与老年人观点之间的一致性，展示了共同点和差异点。从形式和功能的角度探讨独立性，为了解功能在确定随着时间推移维持独立性方面的重要性提供了重要的认识。
