Dataset Information

The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.

ABSTRACT: Background: Co-morbidity is a major late-life challenge with poor outcomes, yet many older people are resilient. We consider an ecopsychosocial framework of resilience to investigate this disparity. This theorises that sources of resilience may be personal, social and structural. We explored older people's responses and reactions to significant life experiences, to understand resilience development for managing later life health challenges. Methods: We applied a two-stage, cross-sectional mixed-methods design to the Cognitive Function and Ageing Studies Wales (CFAS Wales). Participants' defined quantitatively as resilient (high level of well-being despite co-morbidity) were identified in the wave 1 dataset. A sub-sample of the resilient participants aged 65+ were randomly selected for semi-structured interviews (N = 20). Qualitative thematic analyses were both inductive and deductive. Results: The analyses revealed four primary life experiences reflecting different developmental trajectories. "Early years as formative" and "work and employment as formative" occurred at normative developmental stages in the life-course. In contrast non-normative life events such as loss, bereavement, illness of self, and others underpinned the themes of "adverse events and experiences" and "caring experiences." Four potential mechanisms for resilience were central to these life experiences, reflecting reactions, actions, and development: "character and self-identity;" "approach to life and insight;" "meaningful relationships and belonging." Conclusions: This work contributes further theoretical insights into the ecopsychosocial resilience framework. It highlights the process of interdependence between the individual and the wider environment, suggesting how the availability and accessibility of resources and human agency (protective factors), can influence, and be influenced by, the timing of significant events and experiences. In doing so, it corroborates international healthy ageing policy which recognises resilience as important for a public health response to support older people to adjust to changes and losses experienced in later life. It highlights the importance of current and future policies and services for supporting the management of adverse events earlier in the life-course, and recommends that policies and services take a "long view" on population health and well-being and consider the whole life-course, in addition to specific points in the ageing process.

SUBMITTER: Windle G

PROVIDER: S-EPMC7536341 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.

Windle Gill G Bennett Kate M KM MacLeod Catherine C

Frontiers in medicine 20200922

<b>Background:</b> Co-morbidity is a major late-life challenge with poor outcomes, yet many older people are resilient. We consider an ecopsychosocial framework of resilience to investigate this disparity. This theorises that sources of resilience may be personal, social and structural. We explored older people's responses and reactions to significant life experiences, to understand resilience development for managing later life health challenges. <b>Methods:</b> We applied a two-stage, cross-se ...[more]

PMID: 33072779

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Project description:In Western countries, the concepts of healthy ageing and active ageing, that is, concepts that favour health, participation, and security to increase the quality of life of older people, have become key issues. Hence, the effective design of public green spaces in urban areas is crucial, as visiting these areas encourages social relations and interactions in natural, healthy contexts. Consistent with these perspectives, existing landscape design criteria emphasise the importance of considering not only the functional and aesthetic elements, but also the ecosystemic and biophilic relationships between people and the environment, producing positive effects for both. To maximise the impact of such design criteria, proper engagement strategies are desirable, both to assign an active role to older people themselves and to inform the fine-tuning of the design process according to the specific needs of the local population. This study presents an interdisciplinary co-design method that encourages and informs a biophilic approach by describing the experiences of people in natural environments, actual and designed, through the application of attention restoration theory (ART). The case study was developed through six focus group meetings with older people for the co-design of a restorative area in a community garden in the Ortica district in Milan (Italy). Results show how the main needs expressed by participants can be classified into the ART factors of "compatibility" (a multifunctional garden), "fascination" (sense of contact with nature), and "being away" (metaphorical escape from nursing homes). The garden designed includes biophilic principles that respond to such needs, and specific links with designed elements were identified. For example, "being away" (e.g., isolation from daily routine and visual occlusion of the surroundings) and "compatibility" (e.g., pergola and aesthetic value) are the factors that include the elements that more satisfactorily answer previous needs. "Fascination" also includes many positive aspects, allowing space for improvements (e.g., more water elements, interaction with animals). Implications of the method are discussed, including the importance of subjective experience in informing design, the use of different psychological constructs to describe it, and the methodological alternatives for psychological assessment.

Project description:BackgroundComorbid mental health conditions are common in people with epilepsy and have a significant negative impact on important epilepsy outcomes, although the evidence is mostly from high-income countries. This systematic review aimed to synthesise evidence on the association between comorbid mental health conditions and quality of life and functioning among people with epilepsy living in low- and middle income countries (LMICs).MethodsWe searched PubMed, EMBASE, CINAHL, Global Index medicus (GID) and PsycINFO databases from their dates of inception to January 2022. Only quantiative observational studies were included. Meta-analysis was conducted for studies that reported the same kind of quality of life and functioning outcome. Cohen's d was calculated from the mean difference in quality-of-life score between people with epilepsy who did and did not have a comorbid depression or anxiety condition. The protocol was registered with PROSPERO: CRD42020161487.ResultsThe search strategy identified a total of 2,101 articles, from which 33 full text articles were included. Depression was the most common comorbid mental health condition (33 studies), followed by anxiety (16 studies). Meta-analysis was conducted on 19 studies reporting quality of life measured with the same instrument. A large standardized mean effect size (ES) in quality of life score was found (pooled ES = -1.16, 95% confidence interval (CI) - 1.70, - 0.63) between those participants with comorbid depression compared to non-depressed participants. There was significant heterogeneity between studies (I2 = 97.6%, p < 0.001). The median ES (IQR) was - 1.20 (- 1.40, (- 0.64)). An intermediate standard effect size for anxiety on quality of life was also observed (pooled ES = -0.64, 95% CI - 1.14, - 0.13). There was only one study reporting on functioning in relation to comorbid mental health conditions.ConclusionComorbid depression in people with epilepsy in LMICs is associated with poor quality of life although this evidence is based on highly heterogeneous studies. These findings support calls to integrate mental health care into services for people with epilepsy in LMICs. Future studies should use prospective designs in which the change in quality of life in relation to mental health or public health interventions across time can be measured.

Dataset Information

The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.

Publications

The Influence of Life Experiences on the Development of Resilience in Older People With Co-morbid Health Problems.

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