The effects of an empowering self-management model on self-efficacy and sense of coherence among retired elderly with chronic diseases: a randomized controlled trial

Abstract

BackgroundBeing elderly and retired are related phenomena that overlap in a time symmetry. The present study aimed to assess the effect of an empowering self-management model on the self-efficacy and sense of coherence (SOC) in retired elderly with chronic diseases.MethodsA randomized controlled trial that included 60 elderly people was carried out in Bushehr (Iran) in 2016. The participants were randomly assigned to either a control group or an intervention group. Based on an empowering self-management model, the intervention group participated in a five-stage plan: 1) self-awareness of changes and understanding their personal level of performance and expectations; 2) optimal goal setting; 3) planning; 4) adjusting physical, psychological, and social structures; and 5) evaluation. Self-efficacy and SOC were measured using the questionnaires developed by Sherer and Antonovsky, respectively, before and after the intervention. The results of the observed differences between the groups were subsequently compared. Data were presented as mean±SD.ResultsThe mean change of the self-efficacy score in the intervention and control groups was 9.48±5.32 and 1.68± 6.04, respectively, (t[56]=5.20, P<0.001). The mean change of the SOC score in the intervention and control groups was 24.17±12.05 and 0.10±13.42, respectively, (t[56]=7.18, P<0.001).ConclusionThe applied empowering self-management model led to an improved self-efficacy and SOC among the retired elderly with chronic diseases. This model can be used to empower the elderly to achieve comprehensibility, manageability, and meaningfulness in their lives.

SHAPE: A Healthy Aging Community Project Designed Based on the Salutogenic Theory

“…While five studies evaluated on health education interventions related to self-management [43][44][45][46][47], three studies focused on exercise training interventions [48][49][50] and one study evaluated an intergenerational program involving older adults to read picture books to children [51]. Among the five health education interventions, four of them yielded promising findings in enhancing SOC of older adults [43][44][45]47]. The three exercise training interventions differed in the duration of intervention, ranging from 12 [50], 24 [48] and 36 weeks [49].…”

“…Drawing attention to the health education interventions, the authors identified two common characteristics of the four interventions which yielded significant post-test SOC improvements [43][44][45]47]. These two characteristics might shed some light on SOC-enhancing strategies.…”

“…Firstly, these four health education interventions involved active engagement of older adults to be aware of own abilities, resources and health situations. Such intervention engagement was delivered in the form of interactive group activities [47], individual face-to-face interviews using assessment forms [44,45] or senior meeting discussions and a home visit [43]. Secondly, these four interventions equipped and empowered older adults with knowledge on coping strategies of various aspects, ranging from managing daily living needs, aging-related issues, home safety and healthy lifestyle behaviours.…”

Core Self-Evaluations Affecting Retirement-Related Outcomes

“…Research has shown that different individual and contextual aspects, such as age and expected retirement age [ 8 , 39 ], gender [ 41 , 42 ], health [ 43 ], financial situation [ 44 ], job involvement/centrality [ 3 , 45 ], and psychological aspects/resources [ 7 ] can affect retirement planning/preparation. In particular, in term sof personal resources, some empirical studies showed that the first order factors (i.e., self-efficacy, self-esteem, internal locus of control, and emotional stability) included in the core self-evaluations significantly affected retirement-related outcomes.…”

Self-Efficacy in a Nursing Context

“…Community and individual empowerment are one of the key health promotion principles stated in the Ottawa Charter for health promotion that focuses on enabling people to exercise more control over their health, environment and health choices [58]. Besides, an intervention study using an empowering selfmanagement model that focused on selfawareness, goal setting, planning, adjusting physical, psychological and social structures, and evaluation was found to improve self-efficacy and sense of coherence among elderlies with chronic diseases [59]. In particular, selfefficacy is strongly related to the competence component of the empowerment concept, and it plays a critical role in the initiation and maintenance of positive behaviour change and is a vital mechanism for effective self-management [39,60,61].…”