Psychosocial Well Being for Older Adults in The Community Article Summary

Psychosocial Well Being for Older Adults in The Community Article Summary Psychosocial Well Being for Older Adults in The Community Article Summary I don’t know how to handle this Psychology question and need guidance. Summarize the attached article APA 7. The paper should be single spaced versus double spaced. does_life_story_work_improve_psychosocial_well_being_f Lai et al. BMC Geriatrics (2018) 18:119 RESEARCH ARTICLE Open Access Does life story work improve psychosocial well-being for older adults in the community? A quasi-experimental study Claudia K. Y. Lai1*, Ayumi Igarashi2, Clare T. K. Yu1 and Kenny C. W. Chin3 Abstract Background: Previous studies have demonstrated that life story work has positive effects when used on older adults. This study aimed to examine the effect of life story work on the general mental well-being, self-esteem, and life satisfaction of older adults by comparing two groups – one with and one without depressive symptoms. Methods: A quasi-experimental design was adopted in this study. One hundred and twenty-three adults aged 60 or above were recruited from community centers through convenience sampling. They were allocated into two groups based on their level of depressive symptomatology as measured by the Geriatric Depression Scale (GDS). The intervention was to produce a written life story with pictures and memorabilia in four to six semi-structured sessions facilitated by trained volunteers. The outcome measures included general mental well-being (General Health Questionnaire, GHQ), life satisfaction (Life Satisfaction Scale Index A, LSI-A), and self-esteem (Rosenberg’s Self-esteem Scale, RSES). Data were collected at baseline (T0), immediately post-intervention (T1), and at the 3-month follow-up (T2). Generalized estimating equations were used to examine the effect of the intervention on the outcomes. Results: There was a significant interaction effect between the two groups at T1 (? = 0.244, p < 0.05) with improvements in the GHQ observed in the group with depressive symptomology. No significant time and interaction effects were seen on the LSI-A and RSES. The Friedman test was also used to examine whether the intervention itself would have any effects on the GDS score, with two groups combined. A reduction in the mean GDS score was found to be close to reaching a level of significance (?2 = 5.912, p = 0.052). Conclusion: The findings of this study provided some preliminary evidence that life story work was effective at improving the general mental well-being of community-dwelling older adults with depressive symptomology. Because older adults with different levels of depressive symptoms might respond differently to life story work interventions, our findings offer interesting directions for future studies – for instance, on what population would benefit the most from Life Story Work and what would be the mechanism that renders Life Story Work effective. Keywords: Life story, Aged, Older adults, Community-dwelling, Mental health, Life satisfaction, Self-concept, Depression Background Biographical, narrative, and reminiscence-based approaches to health and social care work with older adults have been very popular in the past several decades in various parts of the world. The biographical approach values the attitudes, interests, and desires of older adults as the culmination of a lifetime of experiences [1]. Some * Correspondence: [email protected] 1 School of Nursing, The Hong Kong Polytechnic University, Yuk Choi Road, Hung Hom, Hong Kong SAR Full list of author information is available at the end of the article researchers, principally in the US [2] but also in the UK [3, 4], have demonstrated positive outcomes when older adults are provided with opportunities to recall and review their lives. Psychosocial Well Being for Older Adults in The Community Article Summary More recently, many studies have shown that the biographical approach has positive impacts on the cognitive function or psychological wellbeing of older adults [5–7]. In this study, we aimed to examine effects of the use of life story books, a biographical approach, on improving three psychological indicators of older adults in the community, namely, self-esteem, life satisfaction, and general © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated. Lai et al. BMC Geriatrics (2018) 18:119 mental well-being. We also wanted to determine the differences in effect between those with and without depressive symptomatology. Biographical approaches The biographical, narrative, and reminiscence-based approaches include specific reminiscences, life story work, and life review. A common element in the various biographical approaches is the possession of a life story unique to each individual [8]. Because reminiscence refers to a variety of different approaches, Professor Faith Gibson [4], an authority on reminiscence and life story work, urged researchers and clinicians to distinguish between general and specific reminiscence in order to better delineate the effects of their use in the field of gerontology. According to Gibson, general reminiscence is an approach that uses a variety of multi-sensory triggers to stimulate shared conversations on an agreed-upon topic or theme relating loosely to the known background and interests of the participants. Specific reminiscence, on the other hand, refers to the carefully selected, highly focused use of triggers known to closely approximate the detailed life history of the participant, and consistent efforts to stimulate recall during conversations. In fact, life stories, in contrast to simple reminiscences, uncover much more than people’s past lives. They allow for an exploration of an individual’s more recent past, present, and plans and future concerns [1]. Coleman [8] cautioned us to distinguish between reminiscence and life review. A life review is the more intensive review of one’s life, which, more often than not, focuses on the emotionally charged problems in one’s life. Life reviews, therefore, should be facilitated by a professional [8]. Over time, more and more work has been done on using a person’s entire life story instead of a moment of remembering [9]. Atkinson [10] suggested that sharing one’s story is a way of purging, or releasing tension and burdens through validating personal experiences with others, which is central to the recovery process. It helps an individual to come to terms with his or her life [11]. The value of one’s life is affirmed when the feeling of connectedness with oneself and others occurs through the process of producing a life story record of some kind [12]. Psychosocial Well Being for Older Adults in The Community Article Summary The application of biographical approaches as reported in the literature can be broadly classified to three population groups: that of community-dwelling seniors with symptoms of depression or those who might be at risk of suffering from depression [13], those with dementia who reside in nursing homes [14], and those with mental health problems and/or physical illnesses [15]. This paper focuses on the first group – life story work for the psychosocial well-being of community-dwelling seniors. Page 2 of 12 Biographical approaches and psychological well-being There have been many studies on the effects of life story work on those suffering from depression who live in institutions and in the community. For example, using a randomized controlled design Mastel-Smith and his colleagues [16] examined the effects that a communitybased workshop on writing life stories had on 33 older adults suffering from depression. They reported that LSW was an effective intervention. The biographical approach was also found to be effective at improving other dimensions of psychological well-being, such as the selfesteem and life satisfaction of older adults in institutions [17, 18] and in the community [19]. In a randomized controlled trial (RCT), Chiang and his colleagues [18] evaluated whether an 8-week life review group program could improve the self-esteem and life satisfaction of men aged 75 and over living in a nursing home for veterans in Taiwan. Building on this study, the authors also reported the effects of specific reminiscence therapy on the depression, general psychological well-being, and loneliness of males aged 65 and over living in a nursing home [17]. The results of these studies showed that the biographical approach could be effective at improving the psychological well-being of older adults in institutions. The effect of the biographical approach on psychological well-being was also seen in community samples, despite inconclusive evidence about its effectiveness. Lamers conducted an RCT to examine the effect of life reviews as an online-guided self-help intervention for adults aged 40 years and over with moderate symptoms of depression [19]. The results showed that the intervention was effective at improving the depressive symptoms, and the emotional and psychological well-being of both middle–aged and older adults. A study of life reviews employed among non-depressed older adults also reported a significant interaction effect on the depressive symptoms exhibited by community-dwelling older adults [20]. However, Fagerstrom [21] studied the use of individual or group-facilitated autobiography on older adults in retirement communities but observed no significant changes in both groups post-intervention. Gibson highlighted that depressive individuals usually experience a loss of autonomy, confidence and control in their life. To them, reminiscence is a good mean of restoring control by controlling the process of recalling and reconstructing his/her own story [22]. Despite there is some evidence which showed a stronger beneficial impact of biographical approach on older adults with depression, there is currently lack of studies which directly compares the effect of LSB intervention on depressed and non-depressed older adults. Lai et al. BMC Geriatrics (2018) 18:119 Based on the literature, we postulated that LSB would work more effectively on older adults with depressive symptomology. If the biographical approach is a useful intervention worthy of promotion on depressed older adults, professionals in the field need more and better evidence to inform them about its impact in practice. While in many studies the focus was on symptoms of depression as a major outcome of the biographical approach, we consider it is also important to examine the effect of life story work on other psychological variables, such as life satisfaction, self-esteem and general mental well-being. Psychosocial Well Being for Older Adults in The Community Article Summary ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS The following questions were addressed in this study: 1. Would the introduction of the LSB intervention for community-dwelling seniors lead to an increase in their life satisfaction, self-esteem, and mental well-being? 2. Would the effect of the intervention, if any, be sustained 3-months post-intervention? 3. Which group of older adults (with or without depressive symptoms) would benefit more from the intervention? Methods Design This study examined whether the production of a life story book (LSB) – a record of a person’s life history – would lead to a higher level of life satisfaction and self-esteem in older adults in the community. This was a quasiexperimental study that compared the outcomes between two groups (one with depressive symptoms and one without) at baseline (T0), immediately post-intervention (T1), and 3 months post-intervention (T2). Participants Convenience sampling was employed and the study settings were community centers for seniors in the community. The participants were community-dwelling older adults aged 60 and over (in Hong Kong, anyone aged 60 or over can join a center for older adults in their neighborhood), who were able to communicate most of the time (according to the criteria of the Resident Assessment Instrument [RAI] communication scale [23]; and able to understand and speak Cantonese (the dominant Chinese dialect used in the southern Chinese province of Guangdong and Hong Kong). Excluded were those with active major psychiatric illnesses, including schizophrenia, bipolar disorders, and depression; those with any acute or unstable chronic medical conditions including cardiac or lung diseases; those with any active psychosocial crises such as bereavement or relationship problems; those who were blind; and those who were unable to hear even with hearing aids [23]. Eligible Page 3 of 12 seniors were recruited and allocated into two groups. Group 1(G1) consisted of older adults who had a Geriatric Depression Scale (GDS) score of less than 5 (i.e., no symptoms of depression); the second (G2) consisted of older adults with minor depressive symptoms (GDS scores of 5 and 7, with GDS 8 or above being the cut-off score for identifying depressive symptomatology that warrants medical attention [24]. In previous studies [5, 25], the reminiscence approach was shown to have an effect size of 0.5 in improving well-being on older adults. With a significance level (alpha) of 0.05, an effect size of 0.5 and correlation of repeated measure to be 0.4, a sample of 38 could achieve 80% power to detect between group difference and changes at three time-points (pre-intervention, post intervention and follow up). Previous studies on older individuals using the LSB approach revealed a 10 to 15% attrition rate. The final sample size was determined to be 48 participants for each group. Intervention The life story approach for the writing of life story books developed by Lai [26] was used. The LSB approach incorporates a person’s development over the course of his/her lifetime (i.e., from childhood to older age), and his/her psychosocial development and ways of life (e.g., education, marriage, career choices, and hobbies). The production of the LSB is a planned intervention to facilitate the telling or sharing of past events in a person’s life. It eliminates the requirements of a rigid structure such as that of a biography and allows the person to tell his or her story in a more relaxed manner, similar to engaging in a dialogue with an acquaintance. A trained student assistant helped each senior to compile the senior’s life story if he or she were illiterate. The student assistants would scan the seniors’ photographs, take pictures of objects with special meaning as inserts into the LSB, or find pictures related to the stories being told to make the LSB livelier and more colorful (e.g., pictures of the person’s hometown). Psychosocial Well Being for Older Adults in The Community Article Summary Four to six meetings were needed for the seniors and the student assistants to discuss and produce the LSB [26]. These meetings were conducted mostly in the community centers and sometimes in the seniors’ home when the seniors could not go to the centers because of their physical status. The duration of these meetings was scheduled as 60 min. The end product of the intervention was a written story with pictures or other memorabilia. The total number of words, pages and pictures of completed life story books varied among the participants. The same approach was adopted when facilitating the participants to produce their life story books. Still, the end product were influenced by how the individual would like him/herself to be represented in his or her own life story book. The Lai et al. BMC Geriatrics (2018) 18:119 total number of meetings varied among the participants because of the same reason. The volunteers were university students from the nursing department who had completed at least 80% of the required training, which was comprised of a 2-hour handson session held once a week for 6 weeks. Throughout the training program, the student assistants met with the trainer for guidance and feedback. Instrumentation The basic demographic and clinical characteristics of the participants were collected to facilitate the detection of any significant differences within and between groups. These included data on their gender, age, date of birth, education, and number of medical diagnoses. The functional abilities of the participants were assessed using Lawton’s Instrumental Activities of Daily Living scale [27]. The GDS short form was used to detect symptoms of depression [28]. Life satisfaction and a person’s perception of him/herself can be affected by his/her life circumstances. To understand whether any outside impact would likely affect the person’s life, the Revised Life Events Scale [29] were administered to the participants. In addition, the participants were asked if they were experiencing any financial strain [30]. The outcome measures included the Life Satisfaction Scale Index A (LSI-A) [31]; the Rosenberg’s Self-esteem Scale (RSES) [18]; and the General Health Questionnaire-30 (GHQ) [32]. The GHQ is one of the most commonly used assessments of mental well-being [33]. All of the aforementioned measures had good psychometric properties and had been validated for use in the Hong Kong Chinese population.Psychosocial Well Being for Older Adults in The Community Article Summary Ethical approval to conduct the study was obtained from the Human Subjects Ethics Sub-committee of the School of Nursing, The Hong Kong Polytechnic University (equivalent to the Institutional Review Boards in Western countries). Because some of the participants in G2 were experiencing some minor symptoms of depression, the team instituted a protocol to support them in order to prevent any untoward events or outcomes. Research personnel, including the student assistants, were trained to become sensitive to the participants’ cues, for example, exhibiting behaviors that indicated that they did not want to continue or were unsuitable to continue with the session or project. A back-up and referral system was in place for the participants should they become emotionally disturbed or depressed during the course of the study. Procedures Eligible participants of the social centers were approached and their written informed consent was obtained. Recruited participants were assigned to either G1 or G2 Page 4 of 12 based on the inclusion and exclusion criteria. A research assistant who was not involved in the delivery of the intervention collected the assessment data. During each visit the volunteer would establish a quiet and relaxed atmosphere at the social center, ensuring that the G1 or G2 participant felt comfortable and could engage in the processes without interruptions. The student assistants would facilitate the process with the use of semi-structured questions about the life of the participant, which was developed by the first author of the team. The student visited each participant weekly for 4 to 6 weeks or until the LSB was completed. Data analysis SPSS 24 for Windows was used to manage and analyze the data. Descriptive statistics were used to summarize the characteristics of the sample. The sample characteristics at baseline for those who did not have depressive symptoms versus those who had were compared. Nonparametric tests were adopted because of the relatively small sample size. The Mann-Whitney U test was used to examine the difference between groups for continuous variables, whereas the Chi-square test and Fisher’s Exact test were used for categorical variables. For the multiple response variables, the Chi-square statistics were adjusted with the first-order Rao-Scott correction. To minimize the potential risk of confounding and selection bias among the variables, ANCOVA (Analysis of Covariance) was used on baseline data to select the variables to be included in the multivariate Generalized Estimating Equation (GEE) model for further analysis. The variables that were found to be significant at a p value of < 0.05 in ANCOVA were selected as covariates. GEE modeling was used to measure changes in outcomes at each time point in relation to the baseline. All models … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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