Multiple Chronic Conditions, Resilience, and Workforce Transitions in Later Life: A Socio-Ecological Model

Jason, Kendra; Carr, Dawn; Washington, Tiffany; Hilliard, Tandrea; Mingo, Chivon A.

doi:10.1093/geront/gnv101

Cited by 26 publications

(31 citation statements)

References 45 publications

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“…Despite this international interest, reviews conclude that far less is known about resilience in later life compared to childhood resilience [e.g., (11,12)]. Quantitative research demonstrates the importance of resilience for well-being when living with ill-health (13), reducing the impact of a new chronic condition on disability (14), adjustment to multiple chronic conditions (15), and moderating the impact of daily stress on negative emotions (16). However, this does not reveal how resilience may have developed as these models are constrained by prior theoretical assumptions or limited data and, therefore, are unable to discover new processes (17).…”

Section: Introductionmentioning

confidence: 99%

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

2020

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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 Windle et al. Life Experiences and Resilience 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.

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Section: Introductionmentioning

confidence: 99%

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

2020

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“…Whilst our comorbidity measure captured important dimensions of illness burden including chronicity, disability and psychiatric symptoms; counts of LLI's or specific diagnoses combinations were not captured. Since dose-response associations between the accumulation of chronic illnesses and employment exits have been observed [6,[14][15][16], a comorbidity measure which captured the number of LLI's may have identified stronger associations with specific employment exit routes. Furthermore, the measure of LLI did not exclude mental disorders, which could have led to some misclassification in the morbidity categories.…”

Section: Limitationsmentioning

confidence: 99%

“…This issue is particularly relevant among older workers since comorbidity is more prevalent in this group [11], and may increase the likelihood of employment exits due to greater disability and poorer occupational functioning [12,13]. Studies examining comorbidity as a broad construct suggest that it affects older workers' employment exits, possibly in a dose-response manner [6,8,[14][15][16][17], and additive effects of depression and heart disease on labour market participation have also been observed [18]. Yet, others have found no effect of depressive symptoms among those with chronic disease on working until retirement [4].…”

Section: Introductionmentioning

confidence: 99%

The impact of longstanding illness and common mental disorder on competing employment exits routes in older working age: A longitudinal data-linkage study in Sweden

et al. 2020

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Objectives Comorbidity is prevalent in older working ages and might affect employment exits. This study aimed to 1) assess the associations between comorbidity and different employment exit routes, and 2) examine such associations by gender. Methods We used data from employed adults aged 50-62 in the Stockholm Public Health Survey 2002 and 2006, linked to longitudinal administrative income records (N = 10,416). The morbidity measure combined Limiting Longstanding Illness and Common Mental Disordercaptured by the General Health Questionnaire-12 (�4)-into a categorical variable: 1) No Limiting Longstanding Illness, no Common Mental Disorder, 2) Limiting Longstanding Illness only, 3) Common Mental Disorder only, and 4) comorbid Limiting Longstanding Illness +Common Mental Disorder. Employment status was followed up until 2010, treating early retirement, disability pension and unemployment as employment exits. Competing risk regression analysed the associations between morbidity and employment exit routes, stratifying by gender.

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“…The model emphasises the multilevel environmental context. These ecological systems inevitably interact with each other and influence all aspects of human life (Bronfenbrenner, 1979; Jason, Carr, Washington, Hilliard, & Mingo, 2017). Therefore, in the development of interventions, consideration of multiple level influences is required (Jason et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Influence of group resilience on job satisfaction among Korean nurses: A cross‐sectional study

Son

Ham

2020

Journal of Clinical Nursing

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Purpose This study examined whether the individual and organisational factors of ecological systems theory are associated with job satisfaction among nurses in South Korea. Background Nursing shortages and high turnover rates are a global issue in healthcare settings, and job satisfaction is significantly associated with the turnover intention of nurses. Therefore, efforts to promote job satisfaction are needed to decrease the high turnover rates among nurses and promote care quality and patient safety. Design A cross‐sectional study was performed. This paper adhered to the STROBE guidelines. Methods A sample of 438 nurses working in five secondary or tertiary hospitals was surveyed. The study instruments included work–life balance, resilience, insomnia and job satisfaction. Results Using multilevel analysis, both individual and organisational factors were associated significantly with job satisfaction, and variance at the group level accounted for 19.98% of the total variance of job satisfaction. Among the individual factors, marital status and work–life balance were significantly associated with job satisfaction. At the organisational level, the group mean resilience score was significantly associated with job satisfaction (p < .05). Conclusion The psychosocial characteristics of individual nurses and their affiliated groups (nursing units) were significant in explaining the job satisfaction of nurses. Relevance to clinical practice Both individual‐focused and group‐focused interventions are needed to improve job satisfaction and decrease the turnover intention.

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Multiple Chronic Conditions, Resilience, and Workforce Transitions in Later Life: A Socio-Ecological Model

Cited by 26 publications

References 45 publications

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

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

The impact of longstanding illness and common mental disorder on competing employment exits routes in older working age: A longitudinal data-linkage study in Sweden

Influence of group resilience on job satisfaction among Korean nurses: A cross‐sectional study

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