Achieving healthy ageing through the perspective of sense of coherence among senior-only households: a qualitative study.

Objectives: Explore perceptions towards healthy ageing through the perspective of sense of coherence among older adults residing in senior-only households.Methods: A qualitative study using focus group interviews was conducted and appreciative inquiry was adopted as a strengths-based interviewing approach. 27 older adults who either live alone or with their spouses only were involved in six focus group discussions at a community centre in Singapore. Data saturation was achieved and thematic analysis was performed to analyse the data.Results: The four emerging themes were (1) contending evolving vulnerabilities, (2) intrinsic value of health, (3) taking care of oneself is a personal responsibility, and (4) taking one day at a time: outlook towards later part of life. Older adults' underlying pathogenic orientation towards health contributed to their perceived unpredictable confrontations with vicissitudes including illness and death. This played a part to their short outlook towards old age. Consequently, this could limit their will and abilities to seek meaningful pursuits or valued aspirations and movement towards the salutogenic health pole.Conclusion: By reframing the definition of health to pursuing and fulfilling valued accomplishments, optimal health can be achieved regardless of physical health state. This study suggested that sense of coherence towards the pursuit of healthy ageing can be addressed by reducing the unpredictability of ageing-related processes and vulnerabilities (comprehensibility), supporting active adoption of actions which promotes physical, mental and social health (manageability) and individual reflection in making sense of old age to seek motivation in living each day purposefully (meaningfulness).

Supporting the mobilization of health assets among older community dwellers residing in senior-only households in Singapore: a qualitative study.

BACKGROUND: Care activities provided by community health practitioners for older adults primarily focused on disease prevention and management. However, healthy longevity can go beyond disease prevention and management and promote greater well-being by tapping into the accrual of resources that older adults possess using the salutogenic approach. This study explored how health resources are used among older adults who are residing in senior-only households to promote and maintain health, with the intent of providing insights into how community health practitioners can support these older adults via asset-based strategies. METHODS: We adopted a descriptive qualitative study design using focus group discussions. Twenty-seven older adults who either lived alone or with their spouses were purposively sampled from an elderly populated residential estate in Singapore. Six focus group discussions, conducted from December 2016 to May 2017, were audio-recorded, transcribed, and analyzed using thematic analysis. RESULTS: The themes that emerged were 'tapping on internal self-care repository', 'maintaining and preserving informal social support', and 'enabling self by using environmental aids', and an eco-map of aging assets was used to capture an overview of internal and external resources. With the repository of personal strengths, knowledge, and experiences, these older adults were generally resourceful in navigating around their resource-rich environments to cope with everyday life stressors and promote health. However, they were occasionally limited by individual factors that affected their comprehension, access, maintenance, and utilization of resources. CONCLUSION: The eco-map of aging assets can be used as an assessment framework by community health practitioners to recognize, consider, and build a repertoire of resources among these older adults. It serves as a gentle reminder to adopt an ecological approach in considering and tapping into older adults' wide-ranging personal, social, and environmental resources. Community health practitioners can support resource integration as resource facilitators via cognitive, behavioral, and motivational salutogenic pathways to overcome resource mobilization barriers faced by older adults. Such an approach helps older adults to find their internal capabilities and abilities to know who, where, what, and how to seek external resources to identify solutions, creating the intrinsic value to sustain their actions on resource utility.

The effect of a self-help psychoeducation programme for people with coronary heart disease: A randomized controlled trial.

AIM: To examine the effect of a self-help psychoeducation program for people with coronary heart disease in Singapore. BACKGROUND: Cardiac rehabilitation has shown benefits for mitigating many cardiac risk factors and can lead to improvement in health-related quality of life and psychological well-being in people with heart disease. However, traditional hospital-based cardiac rehabilitation faces substantial challenges. A self-management cardiac rehabilitation program offers an avenue to increase uptake and empowers patients to manage their condition at home. DESIGN: A two-arm, randomized controlled trial. METHODS: A total of 129 patients with coronary heart disease were recruited from an outpatient clinic in a public hospital in Singapore from April 2015-January 2016. They were randomly assigned to the intervention group or the control group. Participants in the intervention group received the 4-week home-based self-help psychoeducation program. Outcomes were measured at baseline and at 4 weeks and 16 weeks from the baseline. RESULTS: There were no significant differences in health-related quality of life, psychological status (i.e., perceived stress level, anxiety, and depression levels), or cardiac physiological risk parameters between the intervention and the control groups immediately after the program or at different time points. There was also no significant difference in unplanned health service use at the 16 week posttest point between the two groups. CONCLUSIONS: This study did not find any significant effect of our program on outpatients with coronary heart disease. Nonetheless, findings on participant characteristics may offer healthcare professionals valuable insights to help facilitate future development of an effective cardiac rehabilitation program catered to outpatients with coronary heart disease. TRIAL REGISTRATION: The study has been registered with ISRCTN registry. The trial registration number is ISRCTN15839687.