Distribution and evaluation of sense of coherence among older immigrants before and after a health promotion intervention – results from the RCT study promoting aging migrants’ capability

Abstract

BackgroundThe migration process can be a threat to a person’s sense of coherence (SOC) and to their ability to experience life as comprehensible, manageable, and meaningful. Seen from a salutogenic perspective, this may have a negative impact on the experience of health.PurposeWe describe the distribution of SOC and its components among older persons with an immigrant background now aging in Sweden. In addition, we evaluated whether a group-based health promotion program with a person-centered approach could support the SOC among older persons in this group.Materials and methodsA randomized controlled trial with postintervention follow-ups at 6 and 12 months was conducted with 131 independently living persons aged ≥70 years from Finland and the Balkan Peninsula. Participants were randomly allocated to an intervention group (4 weeks of group intervention and one follow-up home visit) and a control group (no intervention but access to ordinary health care services). The outcome measure was the SOC measured by SOC-13. Chi-square and ORs were calculated.ResultsThere was a significant improvement in total SOC scores for the intervention group at 6-month follow-up. Also, the ORs for the SOC components were higher in the person-centered intervention group. However, we found no significant between-group differences nor did the effect last until the 12-month follow-up.ConclusionPersons who have lived a long time in a host country after migration seem to have a SOC similar to native-born persons. Interventions with a person-centered approach could support the SOC by capturing individual life situations. Such interventions could support older persons by making everyday life more comprehensible and manageable and helping them to cope with challenges in daily life caused by aging.

Lifetime prevalence of polyvictimization among older adults in Sweden, associations with ill-heath, and the mediating effect of sense of coherence

“…Both SOC and social support affected the association between victimization and ill-health. Though not conclusive, previous findings suggest that SOC can be promoted in interventions among older adults, especially when interventions are sustained over several months [ 62 , 63 ]. SOC was also found to increase after group therapy for adult women who were sexually abused as children [ 64 ].…”

SHAPE: A Healthy Aging Community Project Designed Based on the Salutogenic Theory

“…While five studies evaluated on health education interventions related to self-management [43][44][45][46][47], three studies focused on exercise training interventions [48][49][50] and one study evaluated an intergenerational program involving older adults to read picture books to children [51]. Among the five health education interventions, four of them yielded promising findings in enhancing SOC of older adults [43][44][45]47]. The three exercise training interventions differed in the duration of intervention, ranging from 12 [50], 24 [48] and 36 weeks [49].…”

“…Drawing attention to the health education interventions, the authors identified two common characteristics of the four interventions which yielded significant post-test SOC improvements [43][44][45]47]. These two characteristics might shed some light on SOC-enhancing strategies.…”

“…Firstly, these four health education interventions involved active engagement of older adults to be aware of own abilities, resources and health situations. Such intervention engagement was delivered in the form of interactive group activities [47], individual face-to-face interviews using assessment forms [44,45] or senior meeting discussions and a home visit [43]. Secondly, these four interventions equipped and empowered older adults with knowledge on coping strategies of various aspects, ranging from managing daily living needs, aging-related issues, home safety and healthy lifestyle behaviours.…”

“…Secondly, these four interventions equipped and empowered older adults with knowledge on coping strategies of various aspects, ranging from managing daily living needs, aging-related issues, home safety and healthy lifestyle behaviours. Three out of four of these health education interventions even provided educational booklets related to these specific topics [43][44][45]. On side note, the only health education interventional study which reported decreased SOC scores in both intervention and control groups might have minimal faceto-face active engagement to allow for the deep learning of resources and sharing of knowledge on coping strategies [46].…”