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UNIVERSITY OF OULU P.O. Box 7500 FI-90014 UNIVERSITY OF OULU FINLAND
ACTA UNIVERSITATIS OULUENSIS
SERIES EDITORS
SCIENTIAE RERUM NATURALIUM
HUMANIORA
TECHNICA
MEDICA
SCIENTIAE RERUM SOCIALIUM
SCRIPTA ACADEMICA
OECONOMICA
EDITOR IN CHIEF
EDITORIAL SECRETARY
Professor Mikko Siponen
Professor Harri Mantila
Professor Juha Kostamovaara
Professor Olli Vuolteenaho
Senior Assistant Timo Latomaa
Communications Officer Elna Stjerna
Senior Lecturer Seppo Eriksson
Professor Olli Vuolteenaho
Publications Editor Kirsti Nurkkala
ISBN 978-951-42-8636-0 (Paperback)
ISBN 978-951-42-8637-7 (PDF)
ISSN 0355-3221 (Print)
ISSN 1796-2234 (Online)
UNIVERSITATIS OULUENSIS
MEDICA
ACTA
D
OULU 2007
D 954
Danica Železnik
SELF-CARE OF THE HOME-
DWELLING ELDERLY PEOPLE
LIVING IN SLOVENIA
FACULTY OF MEDICINE,
DEPARTMENT OF NURSING SCIENCE AND HEALTH ADMINISTRATION,
UNIVERSITY OF OULU;
FACULTY OF HEALTH SCIENCES,
UNIVERSITY OF MARIBOR
D 954 ACTA Danica Železnik
D954etukansi.kesken.fm Page 1 Wednesday, October 24, 2007 3:08 PM
ACTA UNIVERSITATIS OULUENSIS
D Medica 954
DANICA ŽELEZNIK
SELF-CARE OF THE HOME-
DWELLING ELDERLY PEOPLE
LIVING IN SLOVENIA
Academic dissertation to be presented, with the assent of
the Faculty of Medicine of the University of Oulu, for
public defence in Kajaaninsali (Auditorium L6), Linnanmaa,
on November 30th, 2007, at 12 noon
OULUN YLIOPISTO, OULU 2007
Copyright © 2007
Acta Univ. Oul. D 954, 2007
Supervised by
Professor Helvi Kyngäs
Doctor Kaisa Backman
Professor Dušanka Mičetić-Turk
Reviewed by
Professor Emerita Maija Hentinen
Docent Riitta Suhonen
ISBN 978-951-42-8636-0 (Paperback)
ISBN 978-951-42-8637-7 (PDF)
http://herkules.oulu.fi/isbn9789514286377/
ISSN 0355-3221 (Printed)
ISSN 1796-2234 (Online)
http://herkules.oulu.fi/issn03553221/
Cover design
Raimo Ahonen
OULU UNIVERSITY PRESS
OULU 2007
Železnik, Danica, Self-care of the home-dwelling elderly people living in Slovenia
Faculty of Medicine, Department of Nursing Science and Health Administration, University of
Oulu, P.O.Box 5000, FI-90014 University of Oulu, Finland; Faculty of Health Sciences, University
of Maribor, Žitna ulica 15, SI-2000 Maribor, Slovenia
Acta Univ. Oul. D 954, 2007
Oulu, Finland
Abstract
This study is focused on the self-care of home-dwelling elderly people living in Slovenia. The study
has two phases. The purpose of the first phase is to describe the self-care of home-dwelling elderly
people living in Slovenia and factors connected to self-care. The purpose of the second phase is to
describe the experiences of the elderly people's ability to manage at home. The aim of this study was
to produce new knowledge about the self-care of home-dwelling elderly people living in Slovenia and
the factors connected with it. The knowledge will be used to develop elderly care and support eldery
people who live at home. The knowledge can be also used to educate nurses to care for the elderly
people.
The study was both quantitative and qualitative. In the quantitative study the sample consisted of
302 home-dwelling elderly people who were clients in domiciliary care. The selection criteria was:
aged 75 years or over and the ability to communicate, no hearing problems, no severe mental
problem/cognitive disability and gave full consent for their participation.
The whole instrument consists of 91 items. A instrument covers background data, types of self-
care, self-care orientation, life satisfaction, self-esteem and functional ability. In the qualitative study,
20 interviews were carried out and a qualitative analysis obtained. Data collection methods included
open-ended questions concerning the following topics: background data, types of self-care, self-care
orientation, life satisfaction, self-esteem and functional ability.
Based on factor analyses, four factors were found which described the self-care. All other factors
describe elderly people's perceptions concerning either the past or the future. The elderly people who
are able to manage their daily activities/routines have a good functional capacity, good family
relations, live qualitatively, accept the future healthily and clearly and are satisfied with their life
because they can take care of themselves, but their self-esteem is not so high. Those elderly people
who do not take care of themselves are abandoned; they are not satisfied with their way of life and
have low-esteem.
The results are going to be the basis for planning care and nursing care for all caregivers,
especially community nurses. On the basis of this result the model of nursing and social care for home
-dwelling elderly people living in Slovenia could be planned.
Keywords: aged, functional ability, home-dwelling elderly people, life satisfication, self-
care, self-esteem, self-orientation
5
Acknowledgement
This study was carried out at the University of Oulu, Department of Nursing in
Finland. I would like to express my sincere thanks to all those who have been of
special importance to me at all stages of this work.
I would like to take this opportunity to extend my warmest thanks to my
dean, prof. dr. h. c., dr. Dušanki Mičetić – Turk for idea that I start my PhD at
University of Oulu and for all her help and support. I wish to thank prof. Dr. Arja
Isola for all her warmest help and support and dr. Kaisa Backman for all help and
kindly attitude at the beginning of my study. My especial thanks go to my
supervisor, prof. Dr. Helvi Kyngäs, who has given me invaluable help and
support. I wish my warmest thanks also to both referees prof. dr. Maija Hentinen
and prof. dr. Riitta Suhonen for their comments what helped me finished this
work. I am grateful to docent Päivi Voutilainen who is commited to opponent me.
Especially I am very grateful to Mrs. Alenka Marsel for all her invaluable
help and encouragement, without her I could not finish this work.
I would like to give my special thanks to Mr. Alojz Tapajner and to librarian
Mrs. Nevenka Balun and Mrs. Simona Novak.
Warm thanks go to my dearest friend and colleague Mrs. Antonija Ivanuša for
her warm support, empathy, personal growth and friendship.
I have to thank also to my English teacher Mr. Miran Jarc. Thanks goes also
to all community nurses expecialy to Mrs. Tatjana Geč.
Finally, I would like to thank my family for understanding and support from
the bottom of my hart, to husband Milan, daughter Polonca and son Uroš. Without
them I could not make it.
6
7
Contents
Abstract
Acknowledgement 5
Contents 7
1
Introduction 9
1.1
Background of the present study 9
1.2
Context of the study 11
1.2.1
Principles and general rights of elderly people in the field
of health care in Slovenia 12
1.3
Purpose of the study 15
2
Self-care of the elderly people 17
2.1
Definitions of self-care 17
2.2
Self-care and factors connected to it 19
2.2.1
Functional capacity 20
2.2.2
Life satisfaction 21
2.2.3
Self-esteem 22
2.2.4
Self-care and disability 23
2.2.5
Self - care of the elderly related to mental health 24
2.3
Self-care of elderly people, quality of life and well-being 25
3
Background theory of the study 29
4
Aim of the study and research problems 31
5
Methodology 33
5.1
Sampling 34
5.1.1
Phase I 34
5.1.2
Phase II 37
5.2
Data collection 38
5.2.1
Phase I 38
5.2.2
Phase II 40
5.3
Data analyses 41
5.3.1
Phase I 41
5.3.2
Phase II 42
5.4
Ethical considerations 43
6
Results 45
6.1
The self-care of home-dwelling elderly people 45
6.2
The self-care orientation 55
6.3
The self-esteem of home-dwelling elderly people 57
8
6.4
The life satisfaction of home-dwelling elderly people 58
6.5
The functional capacity of home-dwelling elderly people 58
6.6
Functional capacity, life satisfaction and self-esteem related to
the self-care behavioural styles of home-dwelling elderly people 59
6.7
The experiences of the elderly people concerning their ability to
manage at home 63
6.8
Main findings of the results 65
7
Discussion 67
7.1
Reliability and validity of the study 67
7.1.1
Validity and reliability of the instrument 67
7.2
Validity of qualitative study 71
7.3
Discussion about findings 72
7.3.1
Functional capacity and self-care 75
7.3.2
Life satisfaction of self-care 76
7.3.3
Self-esteem and self-care 77
7.3.4
Self-care connection to functional capacity, life
satisfaction and self-esteem 77
7.4
Discussion about the possibilities for care for home-dwelling
elderly people 78
7.5
Challenges for nursing practice and further research 79
8
Conclusion 81
References 83
Appendices 101
[...]... are: 1 2 3 4 5 6 What is the self-care of the home -dwelling elderly people like? What is the self-care of the home -dwelling elderly people like from the life history point of view? What is the functional capacity of the home -dwelling elderly people like? What is the life satisfaction of the home -dwelling elderly people like? What is the self-esteem of the home -dwelling elderly people like? How are functional... because it is the only one of its kind existing and appropriate to use and because there is no other kind of study concerning the self-care of home -dwelling elderly people living in Slovenia The aim of the theory developed by Backman 2001 was to develop a model to clarify the exisisting knowledge concerning the self-care of home -dwelling elderly people living in Oulu, Finland A grounded theory method... home dwelling elderly people living in Slovenia The study has two phases The purpose of the first phase is to describe the self-care of home -dwelling elderly people living in Slovenia and the factors connected to self–care The purpose of the second phase is to describe the experiences of the elderly people` s ability to manage at home The knowledge of elderly people home dwelling self-care is not clear... the two main trends of selfcare: the nature of the turning-points of life, the way to react, the resources, the meaning of self-care and the experience of ageing The individual histories of self-care were interpreted in terms of these factors, and two main trends of selfcare were recognized: internal, unambiguous self-care and external, ambiguous self-care The responsible and independent types of self-care. .. have been defined and measured in different ways Because of the lack of knowledge of the levels of self care of home -dwelling elderly people this study is based on Backman’s theory 15 1999 of the self care of home -dwelling elderly people According to Backman’s study 2003 and some other studies (Zasuszniewski 1996, Rabiner et al 1997, Blair 1999) the self-care of elderly people is found to be linked to... compliance with the projections of changing the age structure of the population in the future period, the aim of the programme of nurse education in the field of nursing and care of the elderly people in Slovenia is a complementary development of new educational forms in the field of gerontological nursing Prolongation of life period, changing of traditional family styles, homogeneity of retired families, social... worsen their health, too At the end of 1996 the total number of places in general and special institutions of social welfare in Slovenia was 13,202 Of this total number 10,763 places belonged to the institutional care of the elderly people With regard to the population of Slovenia the above facilities for elderly people would suffice for 4% of the population over 65 years of age The programme of institutional... programme of institutional care of elderly people is based on the criteria set in the draft of the National Programme of Social Welfare in Slovenia According to these criteria the institutional network of public service needs to be expanded to be able to provide for 4% of the elderly population According to the analysis of the existing capacities and the size of the population in 1996, 11,499 places, or... pushing away of the biggest growing number of the aged to the social margins; bigger social disstratification and, therewith, the need to offer a differentiated service; changes in values and views on ageing and old age and the need for using new ways of taking care of the elderly population (Toth 2004a, Toth 2004b) 1.3 Purpose of the study This study is focused on the self-care of home dwelling elderly. .. and, on the other hand, mental health problems have an effect on functional capacity and life satisfaction, as well as the quality of life At the end of theoretical framework is introduced the background theory on which this study is based 16 2 Self-care of the elderly people 2.1 Definitions of self-care Any synthesis of the self-care of the elderly people and related factors based on the existing research . The self-care of home -dwelling elderly people 45 6.2 The self-care orientation 55 6.3 The self-esteem of home -dwelling elderly people 57 8 6.4 The life satisfaction of home -dwelling. experiences of the elderly people& apos;s ability to manage at home. The aim of this study was to produce new knowledge about the self-care of home -dwelling elderly people living in Slovenia and the factors. Železnik SELF-CARE OF THE HOME- DWELLING ELDERLY PEOPLE LIVING IN SLOVENIA FACULTY OF MEDICINE, DEPARTMENT OF NURSING SCIENCE AND HEALTH ADMINISTRATION, UNIVERSITY OF OULU; FACULTY OF HEALTH
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Xem thêm: SELF-CARE OF THE HOME- DWELLING ELDERLY PEOPLE LIVING IN SLOVENIA pdf, SELF-CARE OF THE HOME- DWELLING ELDERLY PEOPLE LIVING IN SLOVENIA pdf, 3 Self-care of elderly people, quality of life and well-being, 6 Functional capacity, life satisfaction and self-esteem related to the self-care behavioural styles of home-dwelling elderly people