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Theory and Design of the Community for successful ageing (ComSA) program in Singapore: connecting BioPsychoSocial health and quality of life experiences of older adults.

Identifieur interne : 000391 ( Main/Exploration ); précédent : 000390; suivant : 000392

Theory and Design of the Community for successful ageing (ComSA) program in Singapore: connecting BioPsychoSocial health and quality of life experiences of older adults.

Auteurs : Su Aw [Singapour] ; Gerald C H. Koh [Singapour] ; Chuen Seng Tan [Singapour] ; Mee Lian Wong [Singapour] ; Hubertus J M. Vrijhoef [Pays-Bas, Belgique] ; Susana Concordo Harding [Singapour] ; Mary Ann B. Geronimo [Singapour] ; Zoe J L. Hildon [Singapour, États-Unis, Royaume-Uni]

Source :

RBID : pubmed:31594545

Descripteurs français

English descriptors

Abstract

BACKGROUND

Despite the emphasis on holistic health promotion in community programs for older people, few studies explicitly consider how BioPsychoSocial (BPS) health elements are interconnected and function to improve Quality of Life (QoL). The Community for Successful Ageing (ComSA) program in Singapore focuses on Community Development (CD) initiatives for older people, accounting for BPS theory in its design and content. Biological (B) health is conceived as physiological and cognitive functioning and related biological self-care; Psychological (P) health as feelings of life satisfaction, and Social health (S) as perceived social support and civic engagement. Furthermore, three overlapping sub-constructs are theorized to connect these elements. Namely Bio-Psychological (BP) health in terms of self-perceptions of ageing; the Psycho-Social (PS) aspects of interpersonal communication; and the Socio-Communal (SC) health in terms of civic engagement. BPS health is conceived as distinct from QoL, defined as composed of control, autonomy, self-realisation and pleasure (measured by CASP-19) of the older person. We examined 1) interconnections of BPS constructs and related sub-constructs and 2) their associations with QoL to inform a practical, applied program theory.

METHODS

A baseline survey (n = 321) of program participants (Mean = 70 years, SD = 8.73). All continuous variables were binarized as 'high' if the scores were above the median. Multivariate logistic regression was used to assess 1) the adjusted effect of each BPS construct on CASP-19, and 2) the odds of scoring high on one BPS construct with the odds of scoring high on a related sub-construct (e.g. B and BP health).

RESULTS

The strongest relationship with QoL was markedly with BP self-perceptions of ageing (OR = 4.07, 95%CI = 2.21-7.49), followed by P life satisfaction (OR = 3.66, 95%CI = 2.04-6.57), PS interpersonal communication (OR = 2.42, 95%CI = 1.23-4.77), SC civic engagement (OR = 1.94, 95%CI = 1.05-3.57), and S social support (OR = 1.89, 95%CI = 1.06-3.38). Core B, P and S health were closely associated with their sub-constructs.

CONCLUSION

ComSA CD is tightly coupled to its proposed program theory. It offers classes to improve B self-care and BP self-perceptions of ageing, group-based guided autobiography to improve P life-satisfaction and PS interpersonal communication, and community initiatives that encourage seniors to solve community issues. This holistic approach is likely to enhance ageing experiences and QoL.


DOI: 10.1186/s12877-019-1277-x
PubMed: 31594545
PubMed Central: PMC6784337


Affiliations:


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<term>Aged (MeSH)</term>
<term>Aged, 80 and over (MeSH)</term>
<term>Aging (psychology)</term>
<term>Environment Design (MeSH)</term>
<term>Family (psychology)</term>
<term>Female (MeSH)</term>
<term>Healthy Aging (physiology)</term>
<term>Healthy Aging (psychology)</term>
<term>Humans (MeSH)</term>
<term>Independent Living (psychology)</term>
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<term>Longitudinal Studies (MeSH)</term>
<term>Male (MeSH)</term>
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<term>Self Care (methods)</term>
<term>Self Care (psychology)</term>
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<term>Autosoins (méthodes)</term>
<term>Autosoins (psychologie)</term>
<term>Conception de l'environnement (MeSH)</term>
<term>Enquêtes et questionnaires (MeSH)</term>
<term>Famille (psychologie)</term>
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<term>Vieillissement (psychologie)</term>
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<term>Famille</term>
<term>Qualité de vie</term>
<term>Vie autonome</term>
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<term>Aging</term>
<term>Family</term>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Environment Design</term>
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<term>Humans</term>
<term>Life Style</term>
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<term>Social Support</term>
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<term>Conception de l'environnement</term>
<term>Enquêtes et questionnaires</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mode de vie</term>
<term>Mâle</term>
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<p>
<b>BACKGROUND</b>
</p>
<p>Despite the emphasis on holistic health promotion in community programs for older people, few studies explicitly consider how BioPsychoSocial (BPS) health elements are interconnected and function to improve Quality of Life (QoL). The Community for Successful Ageing (ComSA) program in Singapore focuses on Community Development (CD) initiatives for older people, accounting for BPS theory in its design and content. Biological (B) health is conceived as physiological and cognitive functioning and related biological self-care; Psychological (P) health as feelings of life satisfaction, and Social health (S) as perceived social support and civic engagement. Furthermore, three overlapping sub-constructs are theorized to connect these elements. Namely Bio-Psychological (BP) health in terms of self-perceptions of ageing; the Psycho-Social (PS) aspects of interpersonal communication; and the Socio-Communal (SC) health in terms of civic engagement. BPS health is conceived as distinct from QoL, defined as composed of control, autonomy, self-realisation and pleasure (measured by CASP-19) of the older person. We examined 1) interconnections of BPS constructs and related sub-constructs and 2) their associations with QoL to inform a practical, applied program theory.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>A baseline survey (n = 321) of program participants (Mean = 70 years, SD = 8.73). All continuous variables were binarized as 'high' if the scores were above the median. Multivariate logistic regression was used to assess 1) the adjusted effect of each BPS construct on CASP-19, and 2) the odds of scoring high on one BPS construct with the odds of scoring high on a related sub-construct (e.g. B and BP health).</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>The strongest relationship with QoL was markedly with BP self-perceptions of ageing (OR = 4.07, 95%CI = 2.21-7.49), followed by P life satisfaction (OR = 3.66, 95%CI = 2.04-6.57), PS interpersonal communication (OR = 2.42, 95%CI = 1.23-4.77), SC civic engagement (OR = 1.94, 95%CI = 1.05-3.57), and S social support (OR = 1.89, 95%CI = 1.06-3.38). Core B, P and S health were closely associated with their sub-constructs.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>ComSA CD is tightly coupled to its proposed program theory. It offers classes to improve B self-care and BP self-perceptions of ageing, group-based guided autobiography to improve P life-satisfaction and PS interpersonal communication, and community initiatives that encourage seniors to solve community issues. This holistic approach is likely to enhance ageing experiences and QoL.</p>
</div>
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<Title>BMC geriatrics</Title>
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<Abstract>
<AbstractText Label="BACKGROUND">Despite the emphasis on holistic health promotion in community programs for older people, few studies explicitly consider how BioPsychoSocial (BPS) health elements are interconnected and function to improve Quality of Life (QoL). The Community for Successful Ageing (ComSA) program in Singapore focuses on Community Development (CD) initiatives for older people, accounting for BPS theory in its design and content. Biological (B) health is conceived as physiological and cognitive functioning and related biological self-care; Psychological (P) health as feelings of life satisfaction, and Social health (S) as perceived social support and civic engagement. Furthermore, three overlapping sub-constructs are theorized to connect these elements. Namely Bio-Psychological (BP) health in terms of self-perceptions of ageing; the Psycho-Social (PS) aspects of interpersonal communication; and the Socio-Communal (SC) health in terms of civic engagement. BPS health is conceived as distinct from QoL, defined as composed of control, autonomy, self-realisation and pleasure (measured by CASP-19) of the older person. We examined 1) interconnections of BPS constructs and related sub-constructs and 2) their associations with QoL to inform a practical, applied program theory.</AbstractText>
<AbstractText Label="METHODS">A baseline survey (n = 321) of program participants (Mean = 70 years, SD = 8.73). All continuous variables were binarized as 'high' if the scores were above the median. Multivariate logistic regression was used to assess 1) the adjusted effect of each BPS construct on CASP-19, and 2) the odds of scoring high on one BPS construct with the odds of scoring high on a related sub-construct (e.g. B and BP health).</AbstractText>
<AbstractText Label="RESULTS">The strongest relationship with QoL was markedly with BP self-perceptions of ageing (OR = 4.07, 95%CI = 2.21-7.49), followed by P life satisfaction (OR = 3.66, 95%CI = 2.04-6.57), PS interpersonal communication (OR = 2.42, 95%CI = 1.23-4.77), SC civic engagement (OR = 1.94, 95%CI = 1.05-3.57), and S social support (OR = 1.89, 95%CI = 1.06-3.38). Core B, P and S health were closely associated with their sub-constructs.</AbstractText>
<AbstractText Label="CONCLUSION">ComSA CD is tightly coupled to its proposed program theory. It offers classes to improve B self-care and BP self-perceptions of ageing, group-based guided autobiography to improve P life-satisfaction and PS interpersonal communication, and community initiatives that encourage seniors to solve community issues. This holistic approach is likely to enhance ageing experiences and QoL.</AbstractText>
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<Affiliation>Saw Swee Hock School of Public Health, National University of Singapore, Tahir Foundation Building, 12 Science Drive 2, #08-01, Singapore, 117549, Singapore. awsu@u.nus.edu.</Affiliation>
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<ForeName>Gerald C H</ForeName>
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<Affiliation>Department of Patient and Care, Maastricht University Medical Centre, Maastricht, The Netherlands.</Affiliation>
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<Affiliation>Department of Family Medicine, Vrije Universiteit Brussel, Brussel, Belgium.</Affiliation>
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<ForeName>Susana Concordo</ForeName>
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<AffiliationInfo>
<Affiliation>Bloomberg School of Public Health, The John Hopkins University, Maryland, USA.</Affiliation>
</AffiliationInfo>
<AffiliationInfo>
<Affiliation>Faculty of Public Health and Policy, Department of Global Health and Development, London School of Hygiene and Tropical Medicine, Keppel street, London, WC1E 7HT, UK.</Affiliation>
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<Month>10</Month>
<Day>09</Day>
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