Increased Self-esteem and Decreased Focus on Problems amongst the Elderly Nursing Home Residents - Research Proposal Example

To determine whether community support groups for older adults could lead to a greater sense of wellbeing. Increased self-esteem and decreased focus on physical, social and emotional problems amongst the elderly nursing home residents. Introduction The process of preventing and alleviating social isolation and loneliness among older people is an important area that should be taken seriuosly by all comunity members and health organization. Health promotion services and activities intended to alleviate social isolation and loneliness among older people have long been providing support to develop, improve and maintain social contacts and mental wellbeing. The available research findings suggest that there is a close but complex association between loneliness, social isolation and living alone (Richard 2009). Loneliness, or emotional isolation, is the subjective, unwelcome feeling of lack or loss of companionship while social isolation was considered to be the objective absence or paucity of contacts and interactions between an older person and a social network (Joanna Briggs, 2009). Health promotion was defined as ‘the process of enabling older people to increase control over and improve their health’, derived from the World Health Organisation’s, (2007). The World Health Organisation describes active ageing as the process of optimising opportunities for health, participation, and security in order to enhance quality of life as people age (WHO, 2007). According to (de Jong 1998), there are several norms that regulate the role of older persons in society that may hinder social participation in old age. Like the marginalization of older persons, such as exclusion from health services, credit schemes, income-generating activities and decision-making; negative stereotypes that associate old age with retirement, illness, dependency and poverty; and the inadequacy of institutional options may reduce the opportunities for social participation. Furthermore, age discrimination may induce older adults to adopt age appropriate behaviour. Johnna Briggs study illustrates that older persons may also have a reduced access to mediating social structures due to mandatory retirement practices and the high cost, inaccessibility and lack of awareness of activities and events. In addition, older persons may feel alienated in a changing society, not identifying with cultural events that reflect changing values and morality and with the speed and the priorities of modern society. Literature Review In a study conducted by Altmaier (1996), found that social support was significantly related to life satisfaction. Aquino et al. surveyed 301 community-dwelling elders aged 65 years old and over to determine how demographic variables such as financial status, educational level, and work patterns affect life satisfaction. Results from face-to-face interviews indicated that elders who were working or volunteering showed higher life satisfaction than those who were not working or volunteering. Further, these authors found that participants who engaged in volunteer work had more social supports than those who were not engaged in volunteer work, which in turn led to higher levels of life satisfaction. Altmaier gives the findings that participants who reported low education, socioeconomic levels and who had poor physical health indicated that they had few social supports and low life satisfaction. Joanna Briggs Institute (2005) conducts another study on the social networks of the elderly. The results obtained indicated that participants who reported decreased physical functioning also perceived their social supports as poor. Thus, participants who reported physical difficulties also perceived their social supports to be poor, which may have affected their level of life satisfaction. This actually brings to questions if there is any relationship between social grouping and the wellbeing of older adults thus this study will aim at empirically demonstration of the relationship between social groping and older adults’ wellbeing. Barak (2002) states in his research that, the community partnerships for older adults have accomplished significant results, such as a program that reduces the frequency of repeat hospitalizations by helping frail seniors through the risky transition from hospital back to their own home, and small, but practical changes, such as lengthening the “walk” signals at neighborhood traffic intersections to give older adults more time to cross the street safely. Both types of efforts require agencies and organizations that previously have not worked together to begin coordinating their efforts and combining their resources. These kinds of solutions, which come from outside the traditional medical care system, can have an immediate and lasting effect on the health of older adults in a community Cohen (2000), notes that, inadequate social support is associated with an increase in mortality, morbidity, psychological distress and with a decrease in overall general health and wellbeing of the older adults he argues that Social participation is particularly beneficial for the health of older adults including physical and cognitive functioning and survival. Older people's involvement in physical and social activities helps them to preserve their physical and cognitive abilities and may reduce the dependence associated with ageing. Cohen concludes that better health and functional status are also associated with higher levels of social participation since good physical and mental functioning allows older people to continue participating in society and many social relationships are maintained as part of leisure and physical activities. Studies conducted by the (Richard 2009) emphasized that Social participation appears to confer health through psychosocial pathways like protective healthy behaviors, self-esteem and purpose to life and stress-buffering effects that moderate the influence of stressors on health. He adds that Loneliness weakens willpower and perseverance over time, hampers self-regulation and can lead to self-destructive habits and middle-aged people who are lonely report more exposure to stress. Loneliness and depressive symptoms have strong reciprocal influences in middle-aged and older adults as noted by (Bowling 2007), in his study since lonely people are more likely to withdraw from engaging with others and less likely to seek emotional support. Lonely older adults have also greater age-related increases in blood pressure than non-lonely older adults and may experience difficulties sleeping, what diminishes nightly restorative processes and increases the severity of age-related chronic disorders. From this review it can be seen clearly that much has been done on the community support groups for the older adults in the nursing homes and these various community support groups do lead to the older adults’ wellbeing. Though there are some loopholes to be investigated, this study will therefore seek to determine the relationship between community support groups and social support groups that lead to the well being of older adults in nursing homes of older adults. Research statement The various researches on the relation between social support and physical health will enable us to understand better about the effect of good social support toward physical and mental health, along with a general well-being of the older adults. Many studies have shown that if a high level of social support becomes available to the older adults, it will benefit their overall health in a long run. The importance of social support implies to everyone in our society, ranging from young childhood through older adulthood. The providers of social support can be anyone in society who brings the positive environment and reinforcement to the individuals, especially from their family members and nursing homes. Therefore the purpose of this study is to determine whether community support groups for older adults could lead to a greater sense of wellbeing, increased self-esteem and decreased focus on physical, social and emotional problems amongst the elderly nursing home residents. Objectives The study will be guided by the following objectives: i. To determine how community support groups for the older adults leads to the adults wellbeing in the nursing homes. ii. To find out if provision of support groups for the older adult leads to increased self-esteem and decreased focus on physical, social and emotional problems amongst the elderly. Research questions i. How does the community support groups for the older adults’ leads to the adults’ wellbeing in the nursing home? ii. Explain how provision of support groups for the older adult leads to increased self-esteem and decreased focus on physical, social and emotional problems amongst the elderly? Hypothesis The following hypothesis will be tested to conduct a regression analysis of the variables. Ho: There is a significant regression relationship between the older adults well being and the community social groups support. Operational variables The older adults are the dependent variables where as the community social groups is the predator variable. The study will be conceptualized basing on the variables that will be used in the study. In this conceptual framework it was conceptualized the older adults wellbieng is influenced by community support groups. The focus is on the community members involement in motiveting the older adults while they are in the nursing homes so as to increase self-esteem, and decrease focus on physical, social and emotional problems. The conceptual framework is useful to the study in various ways. The study is based on the premise that community support group plays a significant role in determining the wellbeing of the odler adults. Method Approach The study adopts Quantitative research approach; that compares the use of descriptive analysis and survey design. The researcher will use both direct and indirect methods of data collection. The researcher will apply both probability and non probability sampling procedures so as to obtain the sample size Design The study design will use descriptive analysis and survey design. Descriptive analysis is a method that involves asking a large group of people questions about a particular issue. The study employed descriptive analysis to establish opinions and knowledge about community surpport to the older adults in the nursing homes. Survey design is used so as to obtain responmdents attitudes opinions and belifes in the role of community surpport groups to older adults. The design usefull in that through it the researcher will be able to collect descriptive data by interviewing in the field through observation. Instruments The data will be collected using questionnaires, interview guides, document analysis guide and observation schedule. The questionnaire was preferred for its suitability to this study. It was suitable as a method of data collection because it will allow the researcher to reach a larger sample within limited time. It also ensures confidentiality and thus gathers more candid and objective replies. The questionnaires were prepared both for the surpport group, and nursing staff members. The document analysis method focused on the observation of documents that are relevant to the topic of study interms of the older adults health. Face to face interview was also used because it helped to enlist the cooperation of respondents and establish a rapport with the older adults within the instution. Validity and Reliability of the Instruments It was necessary to ascertain the validity and reliability of the instruments used to collect data so that the research findings could be reliable. In order to ascertain content and face validity, the questionnaires and in-depth interviews will presented to three lecturers in the department of research who are authorities in the area for scrutiny and advice. The contents and impressions of the instruments will be improved based on the authorities’ advice and comments. The questionnaire and interview items will then constructed in a way that they related to each question. That will ensure that all research questions were covered. To ensure reliability of the instruments the researcher will conduct a pilot study in two nurseing homes that take care of the older adults. The main purpose of the pilot study is to check on suitability and the clarity of the questions on the instruments designed, relevance of the information being sought, the language used and the content validity of the instruments from the responses given. After piloting the researcher will correct the items in the instruments. Sampling strategy The study targets to study all nursing homes from the region and all community support group members and all nurse in the nursing centers. All the nursing homes do recieve surpport from verious community centers from the community. The nursing homes will be stratified according to gender. A sample size of 44 nursing homes will be selected, simple rondom sampling will be used to obtain the older adults sample, the researcher will take the record books that entail all the names of the older adults in the institutuon, then give each name a code that is from 1 to 26979 after which the resaercher will pick the sample of 2000 older adults from the list of names. The same will be done to the health officer after which a sample size of 44 officers will be selected Data collection procedures A research permit will be obtained from the Ministry. Copies of the research permit shall be submitted to the nursing home institutions. The directors of the nursing homes shall be contacted prior to the actual research. Then the researcher shall visit the intuitions and create a rapport with the respondents followed by self administration of the research instruments and conducting interviews document analysis and observation of the participants as they conduct their daily activities in the institution. Data analysis techniques The data collected from questionnaires will be analyzed by the use of descriptive statistics (frequencies and percentages). The descriptive analysis is appropriate for this study because it involves the description, analysis and interpretation of circumstances prevailing at the time of study. Statistical techniques will be used to analyze various items of the questionnaire. These included averages, percentages, frequencies and totals. This study will use frequencies and percentages because they easily communicate the research findings to majority of readers Frequencies easily show the number of subjects in a given category. Data collected will be analyzed according to the nature of the response. Once the coding is completed, the responses will be transferred into a summary sheet by tabulating. then tallied to establish frequencies, which will be converted to percentage of the total number. Responses from open-ended questions will be recorded. To determine the frequencies of each response, the number of respondents giving similar answers will be converted to percentages to illustrate related levels of opinion Interviews will be carried out in the sampled institutions. Responses from in-depth interviews will be transcribed. Then organized in themes and categories that emerged. Information from the records on the health stutus of the older adult in terms of wellbeing will be used to complement and to cross check data collected using the main instruments. Above all Statistical Package for Social Sciences will be used to analyse quantitative data. Strategy to increase response rates The researcher will increase response rates by offering a ward to those respondents who fill the questionnaires first and accurately this would actually increase response rates Ethical consideration The researcher will seek ethical approval from the university head of nursing department so as to be in agood position to conduct the research, the nursing home will be brifed on the aims of the study and when the study will be conducted. The respondents will be assured of confidentialility of their responses. Before conducting the interview with the older adults the researcher will brief the respondent to avoid miscommunication. Limitations of the study The study will be limited to only two variables namely: community surpport groups and the older adults wellbeing in the nursing homes. Other relevant variables that have not been covered will form the basis for further research. Benefits of the study The findings of the study would be significant in various ways; the theoretical value would provide greater insight to the nursing home and polcy makers on the factors that contribute to the well being of the older adults. The findings would serve as reference point for the policy makers on management skills that would lead to effective wellbeing of the older adults in the nursing homes. The findings would also enlighten the nursing staff in order to address the problem of how to improve the wellbeing of the older adults. The findings of the study lastly would also benefit the nursing knowledge, by generating more knowleged on how to improve the wellbeing of the older adults in the nursing homes. Bibliography Altman I, Werner CM: (1985) Human Behavior and Environment: Advances in Theory and Research. Vol. 8, Home Environments. New York: Plenum Press Arnetz, B. B. and Theorell, T. 1983. Psychological, sociological and health behaviour aspects of a long term activation programme for institutionalized elderly people. Social Science and Medicine Aquino, J. A., Russell, D. W., Cutrona, C. E., & Altmaier, E. M. (1996). Employment status, social support, and life satisfaction among the elderly. Journal of Counseling Psychology, 43, 480-489. Barak, M.E.M. (2000). The inclusive workplace: An ecosystems approach to diversity management. Social Work, 45 (4), p339, 14p, 3 diagrams, 1 graph. Retrieved From EBSCO host October 15, 2004 Bowling, A. and Stafford, M (2007). How do objective and subjective assessments of neighbourhood influence social and physical functioning in older age? Findings from a British survey of ageing. Social Science and Medicine, 64, 2533-2549. Cohen, S., & Willis, T. A. (2000). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310-357. De Jong Gierveld, J (1998). A review of loneliness: concept and definitions, determinants and consequences. Reviews in Clinical Gerontology, 8, 73-80 The Joanna Briggs Institute. Systematic reviews--the review process, Levels of evidence. Accessed on-line 2009 http://www.joannabriggs.edu.au/ pubs/approach.php Richard, L. Gauvin, L. Gosselin, C. and Laforest, S. (2009). Staying connected: neighbourhood correlates of social participation among older adults living in an urban environment in Montreal, Quebec. Health Promotion International, 24, 1, 46-57 Appendix A - Covering letter You have been invited to take part in this research on whether community support groups for older adults could lead to a greater sense of wellbeing. Increased self-esteem and decreased focus on physical, social and emotional problems amongst the elderly nursing home residents. My name is Myra Phipps and I am undertaking this project as part of my study. I am requesting you to respond to the questionnaires and interview guides genuinely. Approval from the Research and Ethics Committee ensures that individual answers from respondents will be confidential, and no identifying details will be supplied in reports, research discussions or presentations. Filling the questionnaires will take approximately 10 – 15 minutes to complete and you can withdraw at anytime, once you have completed. The interviews will take around 15 minutes if you have any questions regarding the survey please feel free to contact me on this number ---------- I would like to take this opportunity to thank you for your participation. Myra Phipps (Student, Researcher) Read More

Literature Review In a study conducted by Altmaier (1996), found that social support was significantly related to life satisfaction. Aquino et al. surveyed 301 community-dwelling elders aged 65 years old and over to determine how demographic variables such as financial status, educational level, and work patterns affect life satisfaction. Results from face-to-face interviews indicated that elders who were working or volunteering showed higher life satisfaction than those who were not working or volunteering.

Further, these authors found that participants who engaged in volunteer work had more social supports than those who were not engaged in volunteer work, which in turn led to higher levels of life satisfaction. Altmaier gives the findings that participants who reported low education, socioeconomic levels and who had poor physical health indicated that they had few social supports and low life satisfaction. Joanna Briggs Institute (2005) conducts another study on the social networks of the elderly.

The results obtained indicated that participants who reported decreased physical functioning also perceived their social supports as poor. Thus, participants who reported physical difficulties also perceived their social supports to be poor, which may have affected their level of life satisfaction. This actually brings to questions if there is any relationship between social grouping and the wellbeing of older adults thus this study will aim at empirically demonstration of the relationship between social groping and older adults’ wellbeing.

Barak (2002) states in his research that, the community partnerships for older adults have accomplished significant results, such as a program that reduces the frequency of repeat hospitalizations by helping frail seniors through the risky transition from hospital back to their own home, and small, but practical changes, such as lengthening the “walk” signals at neighborhood traffic intersections to give older adults more time to cross the street safely. Both types of efforts require agencies and organizations that previously have not worked together to begin coordinating their efforts and combining their resources.

These kinds of solutions, which come from outside the traditional medical care system, can have an immediate and lasting effect on the health of older adults in a community Cohen (2000), notes that, inadequate social support is associated with an increase in mortality, morbidity, psychological distress and with a decrease in overall general health and wellbeing of the older adults he argues that Social participation is particularly beneficial for the health of older adults including physical and cognitive functioning and survival.

Older people's involvement in physical and social activities helps them to preserve their physical and cognitive abilities and may reduce the dependence associated with ageing. Cohen concludes that better health and functional status are also associated with higher levels of social participation since good physical and mental functioning allows older people to continue participating in society and many social relationships are maintained as part of leisure and physical activities. Studies conducted by the (Richard 2009) emphasized that Social participation appears to confer health through psychosocial pathways like protective healthy behaviors, self-esteem and purpose to life and stress-buffering effects that moderate the influence of stressors on health.

He adds that Loneliness weakens willpower and perseverance over time, hampers self-regulation and can lead to self-destructive habits and middle-aged people who are lonely report more exposure to stress. Loneliness and depressive symptoms have strong reciprocal influences in middle-aged and older adults as noted by (Bowling 2007), in his study since lonely people are more likely to withdraw from engaging with others and less likely to seek emotional support. Lonely older adults have also greater age-related increases in blood pressure than non-lonely older adults and may experience difficulties sleeping, what diminishes nightly restorative processes and increases the severity of age-related chronic disorders.

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