Potential for self-care : Assessing and describing self-care ability among elderly people

Sammanfattning: The aim of this thesis was to explore the nature of elderly people's potential for selfcare from a nursing perspective. The research was performed within an empirical frame of reference as well as within a phenomenological frame at a descriptive and hermeneutical level.In order to implement a relation-searching study, one instrument was translated and a new instrument constructed. Both tools were tested for reliability and validity. A relation-searching study and a phenomenological study were then performed. The participating elderly were 65+ years of age and Jiving in a health district in western Sweden. The study groups consisted of 1) a convenience sample comprising inpatients (n=52) and their caregivers (n=53) in three nursing homes and one geriatric rehabilitation department, 2) a consecutive sample of in-patients (n=57) in a geriatric rehabilitation department, 3) an age stratified random sample, from which 125 persons agreed to participate in the study, and 4) for the phenomenological study, nine persons from the original age stratified random sample participated together with two conveniently chosen persons lrom a pilot study.The in-patients were interviewed, and the home dwelling persons completed a mailed questionnaire and wrote self-reports, respectively. Bivariate and multivariate statistical methods were used in the quantitative studies. The Empirical Phenomenalogical Psychological (EPP) method and a phenomenological-hermeneutical method were used in the analyses of the self-reported narratives.The results showed that the constructed instrument, the Self-care Ability Scale for the Elderly (SASE), is a reliable and valid tool for the appraisal of elderly people's perceived ability for self-care. The Swedish version of the Appraisal of Self-care Agency (ASA) scale is a reliable and valid tool for the appraisal of elderly people's perceived activation of self-care ability. The proposed theoretical relationship between self-care ability and self-care activity was empirically supported. Self-care ability and self-care agency declined for the studied home dwelling elderly 75+ years of age. One hypothesis was generated, saying that self-care ability among elderly people may be reinforced by physical activity and by the development of self-awareness.In the phcnomenological study, the structure of self-care ability among the home dwelling elderly persons was found to be twofold; it entailed, I) being present to the opportunity to act on certain perceived influences on the body and 2) alone or with support from somebody else, to be able to bring about a change in attitude towards ones personal lifestyle or life situation. The meaning of actualising the self-care ability into self-care activity was interpreted as self-realisation and self-transcendence.