Feature ArticleEnhancing mastery and sense of coherence: Important determinants of health in older adults
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.Empty Cell Young-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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