The physical, social and symbolic environment supporting the well-being of home-dwelling elderly people

Abstract

Objectives. The purpose of this study was to construct a theory on an environment that would support the well-being of home-dwelling elderly people in northern Finland. Study design. The study was carried out according to the phases of theory formulation using both qualitative and quantitative methods. Methods. The data of the first phase consisted of focused interviews (n=39) with home-dwelling elderly people over the age of 65 years. Judgement-based snowball sampling was used. By means of inductive concept synthesis, hypothetical models were constructed of a physical, social and symbolic environment that would support the well-being of the elderly. In order to verify the concepts of the hypothetical model, an instrument was constructed in the second phase of the study and its reliability was evaluated by a panel of experts consisting of nurses (n=15), through expert evaluations (n=3) and by postal questionnaire. The final phase of the study (n=328) also targeted home-dwelling elderly people living in northern Finland. The sampling method used was a stratified random sampling. The data of (n=328) were analysed by principal component analysis (PCA) and confirmatory factor analysis (CFA). Results. The physical environment that supports the well-being of the elderly includes a northern environment, an environment that enables safe activity and a pleasant physical environment. The social environment that supports well-being enables the elderly to receive help, allows them to keep in contact with family members and friends as providers of support to their well-being and offers a pleasant living community. The symbolic environment that supports well-being consists of the ideal attributes of well-being, spirituality, the normative attribute of well-being and a sense of history. Conclusions. Even though the environment is artificially divided into separate areas in the theory, in putting the results into practice, it needs to be taken into account that observing separate areas of the environment does not provide a comprehensive view on the connection between environment and well-being.

Nursing Support of the Spiritual Needs of Older Adults Living With Dementia

“…15,26,30,31 Surprisingly, the articles in the review represented a rather narrow interpretation of spirituality, which has been considered an important part of the symbolic environment in the wider literature. 4,32 Therefore, there is need to broaden the importance of the symbolic environment into the nursing environment, which has largely been neglected in nursing research. Nurses working alongside people with dementia could increase the depth of their relationships by taking spirituality and the whole symbolic environment into consideration as a part of holistic nursing practice to enable older adults with dementia to feel valuable and useful.…”

The Effects of Housing on Health and Health Risks in an Aging Population: A Qualitative Study in Rural Thailand

“…Furthermore, homes have become a growing preferred environment for health care delivery, both in developed and developing countries. Several studies, from Europe and the US, have addressed this upcoming trend of health care delivery and found that a more supportive and adequate physical environment can reduce the needs for health care and increase the well-being [17, 20, 23, 33]. When interpreting the results from our study, it is also important to take into account that several of the physical barriers that were observed were, to a large extent, met and solved by family members and health volunteers.…”

Developing and Testing a Middle‐Range Theory of the Well‐Being Supportive Physical Environment of Home‐Dwelling Elderly

“…Several factors associated with Northern environment, such as climate and availability of services, are related to the well-being of the elderly. For example, various cold- or heat-related symptoms during the winter or summer make everyday coping more difficult and weaken the perceived state of health of the elderly [19, 20]. …”

“…The development of the theory is illustrated with an example. The example used here is a theory on a well-being supportive physical environment of home-dwelling elderly people [19, 20]. In the study in question, a descriptive and explanatory middle-range theory was formed based on the experiences of the elderly.…”