Perspectives of older adults with a chronic condition on functioning, social participation and health: a qualitative study

Abstract

Background 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. Methods 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. Results 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. Conclusions 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.

Social Participation Considered as Meaningful in old age − the Perceptions of Senior Housing Residents in Finland

“…A person-centred approach can foster independence as well as social participation, which points to the importance of an active dialogue with senior housing residents about their wishes, needs and functional ability. The information can then be used to help residents to maintain their level of independence and remove barriers for social participation (De Coninck et al, 2021 ).…”

“…This type of social participation involves social engagement and may delay frailty (Jeste et al, 2019 ). Even though all of the participants had reduced functioning themselves, they found it meaningful to care for others and therefore motivated to stay socially active (De Coninck et al, 2021 ). The participants’ attentiveness to other peoples’ needs can be described as altruism and may improve quality of life (Roberts & Adams, 2018 ).…”

“…A key to promoting social participation is the identification of inhibiting and enabling factors (Cachadinha et al, 2011 ; De Coninck et al, 2021 ). A recent systematic review by Townsend et al ( 2021 ) identified four main themes that related to decreased or increased social participation, namely demographic factors, individual/internal factors, environmental factors and social network sizes.…”

Individually Tailored Remote Physiotherapy Program Improves Participation and Autonomy in Activities of Everyday Life along with Exercise Capacity, Self-Efficacy, and Low-Moderate Physical Activity in Patients with Pulmonary Arterial Hypertension: A Randomized Controlled Study

“…Such a way allows more to reflect the experience of patients about living with long-term disease, for example, Hedman et al (2015) research disclosed the perspective of older people living with chronic diseases who describe abilities or disabilities of less importance than meaningful everyday life [ 25 ]. Consequently, promoting more patient-centered approach in the treatment with respect to an individual’s attitudes, social circumstances, personal effectiveness as contributors to participation and well-being in persons living with chronic health condition [ 26 ].…”

Talking about chronic pain in family settings: a glimpse of older persons’ everyday realities

“…Chronic pain is an important factor of vulnerability among this demographic [ 24 , 25 ] and impacts on the whole social environment of the persons who suffer from it [ 26 , 27 ]. To date, despite an increased interest in the social environment of those older members of society who live with chronic health issues [ 22 , 28 ], and the recognition of the need to integrate the resources of their social network into the care of chronic pain [ 29 ], research still provides scant information on the impact of an older person’s social environment on their ability to communicate about their pain [ 30 ].…”