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Exploring the meaning of a good life for older widows with extensive need of care: a qualitative in-home interview study
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-9968-3937
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0002-7388-069X
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0003-0313-6002
Luleå University of Technology, Department of Health, Education and Technology, Nursing and Medical Technology.ORCID iD: 0000-0001-5953-8970
2024 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1, article id 2322757Article in journal (Refereed) Published
Abstract [en]

Introduction: Studies of older women’s life transitions is rare but gains relevance as the aging population, with older women as the majority, expands.

Purpose: To explore the meaning of a good life for older widows with extensive home care needs.

Materials and methods: Semi-structured interviews were carried out with eleven women, aged 80 and over (82–95 years, mean 90) residing at home with extensive care needs (≥4 daily sessions, averaging 2.5–6 hours, mean 3). Data were analysed by reflexive thematic analysis.

Results: The theme “This Day in My Home, the frame of my life” reflects the women’s experience of a good life. A good day imbued them with hope, trust and security, carrying them forward with the assurance that night would usher in a new day. However, there were moments when life was merely about navigating daily challenges. During such days, the women felt trapped in time, unsafe and lonely.

Conclusion: A day at home may seem static, yet it mirrors life’s dynamism, evolving with shifting circumstances. Older widows navigate challenges while maintaining their sense of self, independence, and connection to home. These findings have implications for aged care, recognizing the multifaceted aspects of life and the centrality of home.

Place, publisher, year, edition, pages
Taylor & Francis, 2024. Vol. 19, no 1, article id 2322757
Keywords [en]
Aged 80 and over, independent living, nursing care, women’s health, Thematic Analysis, Aging, Home Care Services, Life Change Events, Home Health Nursing, Widowhood, Qualitative Research
National Category
Nursing
Research subject
Nursing
Identifiers
URN: urn:nbn:se:ltu:diva-104621DOI: 10.1080/17482631.2024.2322757ISI: 001177089100001PubMedID: 38431864Scopus ID: 2-s2.0-85186404144OAI: oai:DiVA.org:ltu-104621DiVA, id: diva2:1845195
Note

Validerad;2024;Nivå 2;2024-04-09 (joosat);

Full text license: CC BY-NC 4.0;

Available from: 2024-03-18 Created: 2024-03-18 Last updated: 2024-04-09Bibliographically approved
In thesis
1. Health in later life: A nursing perspective
Open this publication in new window or tab >>Health in later life: A nursing perspective
2024 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The ongoing demographic shift towards an older population calls for a corresponding shift to a proactive approach, aiming for health and well-being in old age. This dissertation addresses the need for increased knowledge about health in the context of aging at home. It explores the roles of relationships, home, health, and well-being while examining the various factors influencing health. The disseration also explores how key stakeholders in home care organizations percive a good life for older persons. From a nursing perspective, the disseration explores pathways of change and experiences related to health, guided by the caritative caring theory, which underscores health as wholeness and holiness. By thoroughly examining self-rated health, relationships, and the experiences of older persons receiving home support, along with key stakeholders' perceptions, the dissertation aims to provide valuable insights for nursing practices and the promotion of health in later life.

This dissertation aims to explore health in later life, specifically concentrating on widowed women living alone with extensive home care needs. This exploration encompasses both the perspective of older widows and that of key stakeholders. For a comprehensive understanding health, the disseration also study self-rated health among older persons over a 20-year period, exploring its associations to health and well-being factors, including survival. Additionally, the dissertation explores the shared relationship between older women and nurses.

This dissertation comprises one quantitative and three qualitative studies, all centred around older persons aged 80 years and older. Paper I is a quantitative, longitudinal study investigating changes in Self-Rated Health (SRH) across the aging spectrum. The study included 1595 participants initially (aged 59-79) and 541 participants at follow-up (age 80-96). Most participants rated their health as "Quite good" (54.5%) at baseline. Over the study period, 42.6% had stable SRH, 40.6% had declined, and 16.8% had improved. Changes in SRH were at follow-up significantly associated with age, pain, nutrition, cognition, walking aid use, self-paced gait speed, lower extremity strength, independence in activities of daily living, weekly physical exercise, outdoor activity, participation in organized activities, visiting others, morale, and depressive symptoms. SRH at baseline was significantly associated with survival (p<0.05). Paper II is a qualitative study about the concept of a good life for single-living older women with extensive care needs. This involved individual interviews with 11 participants aged 82-95, analysed through reflexive thematic analysis. Paper III is a qualitative description of key stakeholders' perceptions regarding a good life for the oldest old persons living at home with extensive care needs. The study utilized qualitative focus groups with 28 participants aged 31-69 (1 man, 27 women), analysed through qualitative content analysis. Paper IV is a qualitative study that aim to explore the meaning of relationship between older women and registered nurses in home care. The research employed qualitative methods, including focus groups and individual interviews, with 11 older women (aged 82-95) and 5 registered nurses (aged 35-47), analysed using qualitative content analysis. 

In conclusion, health in later life is not merely about avoiding a decline in health; rather, it involves integrating existing aspects into an ever-changing situation. However, challenges such as living alone, experiencing depressive symptoms, and coping with illness and/or functional disability can pose threats, risking overall health and survival. In contrast, for those living with disabilities and illnesses with extensive care needs, the significance of daily life becomes paramount. Simultaneously, the relationship between older women and registered nurse emerges as a recurring connection with the potential not only to enhance daily life but also to serve as a consistent and supportive presence in the home.

Place, publisher, year, edition, pages
Luleå: Luleå University of Technology, 2024
Series
Doctoral thesis / Luleå University of Technology 1 jan 1997 → …, ISSN 1402-1544
Keywords
Aging Population, Home Care Services, Self-Rated Health, Geriatric Nursing, Nurse-Patient Relationship, Health
National Category
Nursing
Research subject
Nursing
Identifiers
urn:nbn:se:ltu:diva-104693 (URN)978-91-8048-507-4 (ISBN)978-91-8048-508-1 (ISBN)
Public defence
2024-05-24, A117, Luleå university of technology, Luleå, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-03-21 Created: 2024-03-20 Last updated: 2024-05-07Bibliographically approved

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Almevall, ArielJuuso, PäiviMelander, CatharinaZingmark, Karin

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