published_or_final_version / Community Medicine / Master / Master of Public Health

published_or_final_version / Community Medicine / Master / Master of Public Health

abstract / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Physical activity (PA) is beneficial for older women, yet, many older women are physically inactive. One way to motivate older women to become physically active is through physically active identity development. This study tested an intervention to see if physically active identity development could be facilitated, and if a facilitated physically active identity resulted in increased PA. A quasi-experimental pre-test post-test design was used with a convenience sample of 43 older women. Data analyses compared those who completed the study versus those who did not complete the study and those assigned to the intervention versus the attention-control group. Those who did not complete the study (N=22) had significantly higher walking frequency (p=.023) and significantly lower duration of sitting (p=.000). Among those who participated in the intervention (N=12) or attention-control (N=9) activities, there were no significant differences in physically active identities or PA at the end of the nine-week study period. Therefore, the study's two hypotheses were not supported. Significant associations were noted between physically active identity measures and health status (p=.039), ego-resiliency (p=.040, p=.016), general fear of performing PA (p=.024), and access to PA (p=.017). Limitations of the study include the high risk of error in the statistical conclusions due to low statistical power, the limitations of the sample, limitations of the intervention itself, and the failure to track subjects longitudinally. Implications for nursing education, practice, and research are discussed. Recommendations for future studies were suggested.

No description available.

No description available.

A descriptive study was conducted to determine the level of self-esteem in elderly women in two different settings, the community and the nursing home, and if there was a difference in the level of self-esteem between the groups. The relationship between self-esteem and the intervening variables of loss, health, role fulfillment, social support, and control was examined. Thirty subjects, aged 69 to 92 years, participated in the study, 15 from the community and 15 from a nursing home. The questionnaire focused on demographic data, intervening variables scales, and the Rosenberg Self-Esteem Scale to determine the level of self-esteem. The data revealed no significant difference of self-esteem between the two groups (p = 0.46). Community subjects showed a significant relationship between self-esteem and financial status (p = 0.001). Nursing home subjects showed significant relationships between self-esteem and age (p = 0.05), self-health (p = 0.004), compared health (p = 0.04), and control (p = 0.001).

No description available.

Arising from personal experience and observations in employment, this thesis considers the working life course experiences of people growing older with long-term physical or sensory disabilities. It uses: work as a fulcrum to examine experience; the concept of the life course to embed disability within the ordinary elements of everyday life; and a social model approach to conceptualise impairment and disability. In addition, Adaptive Theory is used as an approach to the overall study design to recognise both researcher perspective and substantive theory in developing research instruments, data collection techniques and analytical framework. The thesis begins with a research and literature review which identifies some parallels and tensions between the disciplines of Critical Social Gerontology and Disability Studies. Building on exploratory discussions with disabled trade unionists, it then focuses on empirical research with 14 workers aged 40-65, from a range of non-sheltered occupations and disabled by physical or sensory impairments for at least 15 years. In-depth interviews about the intersection of work, ageing and disability examine how each person manages the challenges and opportunities encountered. The findings indicate how the impact of being disabled across the lifecourse is not only structurally influenced and socially constructed but also dynamically contextualised and interwoven into individual self-concept. In moving away from a conventional focus on barriers, discrimination and oppression the thesis demonstrates that a more nuanced approach to lifecourse experiences is fundamental to understanding the process of growing older with a disability. In addition, by defining and accessing participants as ‘workers’ rather than ‘older’ or ‘disabled’ people they proved to be both ‘hidden’ and ‘seldom heard’ in the existing research and literature. In parallel, therefore, the thesis also explores the research process itself by posing questions about the nature of research both in Critical Social Gerontology and in Disability Studies.

The typical cardiac surgery patient is increasing in age and level of frailty. Frailty can be defined as an increased vulnerability to stressors due to decreased physiological reserve. Previous investigations have demonstrated the benefit of cardiac rehabilitation (CR) programming on surgical outcomes. However, the link between pre-operative frailty and post-operative CR completion is unclear. The purpose of this study was to determine if pre-operative frailty status impacts CR completion post-operatively. A total of 114 cardiac surgery patients with an average age of 71 years were included in the analysis. CR completers were significantly less frail than CR non-completers at baseline based on the Clinical Frailty Scale (CFS; p=0.01), Modified Fried Criteria (MFC; p=0.0005), Short Physical Performance Battery (SPPB; p=0.007) and the Functional Frailty Index (FFI; p=<0.0001). The change in frailty status from baseline to 1-year post-operatively was not statistically different between CR completers and non-completers; CFS (p=0.90), MFC (p=0.70), SPPB (p=0.06) and FFI (p=0.07). However, the MFC frailty domains of cognitive impairment (p=0.0005) and low physical activity (p=0.04), in addition to the FFI physical domain of frailty (p=0.009), did significantly improve among CR completers when compared to non-completers. CR attendance measured by swipe card access did not correlate with frailty modifications. Collectively, these data suggest that participants deemed to be frail at the pre-operative time point attend and complete CR less frequently than non-frail participants. Furthermore, CR completion does not appear to modify frailty status overall; although, some frailty domains appear to be more sensitive to change than others. / February 2017