Elsevier

Geriatric Nursing

Volume 22, Issue 1, January–February 2001, Pages 29-32
Geriatric Nursing

Feature Article
Enhancing mastery and sense of coherence: Important determinants of health in older adults

https://doi.org/10.1067/mgn.2001.113532Get rights and content

Abstract

The purpose of the study was to expand existing knowledge of the determinants of health for community-dwelling young-old and old-old people. A subsample (n = 2413) from the Health Canada Supplement to the 1994 National Population Health Survey was analyzed. The factors examined were biographic attributes, sociodemographic indicators, sense of coherence (SOC), mastery, self-esteem, informal social support, and use of health care services. Hierarchical regression analyses revealed that mastery and SOC were strongly related to health status and perceived health. Strategies discussed herein will help practitioners ensure that older adults’ mastery and SOC are supported and enhanced. (Geriatr Nurs 2001;22:29-32)

Section snippets

Design and sample

We used a correlational design to examine the relationships among sociodemographic indicators, psychosocial variables, health services utilization, health status, and perceived health in community-dwelling young-old and old-old people. The data source was the Health Canada Supplement to the 1994/95 National Population Health Survey (NPHS). The target population of the NPHS included Canadian household residents in all provinces except populations on Indian reserves, Canadian Forces bases, and

SOC and mastery in the young-old and old-old

Our findings support the belief that older adults form two distinct groups. The old-old cohort in our study had statistically significant greater percentages of residents who were women; widowed, divorced, or separated; living alone; in the lowest and lower-middle income brackets; with lower education levels; and immigrants, as shown in Table 1.

. Significantly Different Sociodemographic Variables in Young-Old and Old-Old Subjects

Empty CellYoung-Old (65-79 years) (n = 2006)Old-Old (80+ years) (n = 406)
Women

Practice implications and clinical significance

Several strategies may assist policy-makers, program planners, and practitioners in ensuring that the significant determinants of health are addressed and supported. Recognizing that the old-old are at a greater disadvantage than their counterparts (ie, the old-old are more likely to be living alone and have less income, and less education), these strategies may be especially helpful to this population.

Within the current Canadian health care infrastructure, little is done to enhance supportive

Conclusion

Our findings revealed that, in both the young-old and old-old cohorts, SOC and mastery were stronger predictors of health status than the sociodemographic variables. As well, SOC and self-esteem were significant predictors of perceived health in the young-old cohort, whereas mastery was a significant predictor in the old-old cohort. These findings illustrate the importance of these psychologic factors. Strategies that enhance SOC and mastery include implementing models of service delivery that

Acknowledgements

This research was made possible in part by Health Canada through a National Health Research and Development Program Research Training Award and the Canadian Gerontological Nursing Association through a research award.

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