Social participation and quality of life in community-dwelling older adults through the Lifestyle Redesign® program

Abstract

Purpose. The purpose of this study was to evaluate the effect of exercise and Lifestyle Redesign® on social participation and quality of life in community-dwelling older adults. Methods. Twelve community-dwelling adults aged 65 years and older were recruited to participate in the study. The study took place at a senior center located in central Indiana, where activities were provided for low-income seniors from nearby neighborhoods. This study was a mixed methods design study. Ten week occupation-based group activities from the Lifestyle Redesign® program were implemented as intervention. An exercise program was provided on the same days to the same participants as its own control. The order of exercise and intervention was alternated every other week to decrease rater bias. Activities included in the exercise program were line dancing, chair aerobics, yoga, etc. Social participation was measured using the Social Profile at the end of each exercise and intervention session as repeated measures. The inter-rater reliability of the Social Profile was confirmed at the alpha level of 0.84 for its use in the older adult population. Researchers of the study established inter-rater item agreement prior to the start of the study by observing a recorded group activity and independently rated the group. The researchers then compared scores, discussed discrepancies, and came to a consensus on scores. Five group levels are included in the tool: parallel, associative, basic cooperative, supportive cooperative, and mature levels. The researchers averaged the scores of each level within each subscale: activity participation, social interaction, and group membership and roles. Quantitative data was analyzed using descriptive and inferential statistical procedures. Quality of life was explored through semistructured interviews, and then analyzed using thematic analysis. Results. The SPSS version 16.0 was used for quantitative data analyses. The Spearman’s Rank Correlation Coefficient was used for inter-rater agreements. The results indicated moderately high to very high inter-rater agreements in both programs. The Wilcoxon signed-ranks test results indicated statistically significant differences in social participation between the two programs for parallel, basic cooperative, supportive cooperative, and mature levels. However, statistically significant difference for associate/project level was not found. Shapiro Wilks test for normality was conducted to check for normal distributions of the data. Results indicated normal distributions on parallel, associate/project, basic cooperative, and supportive cooperative levels for both programs, therefore, paired sample t-tests were performed. Results showed statistically significant differences in social participation between the two programs for parallel, basic cooperative, and supportive cooperative levels. Overall, the quantitative results showed higher levels of social participation in intervention than in exercise program. Three main themes emerged that supported participants’ quality of life were well-being, peace of mind, and relationships. Five aspects that negatively affected quality of life were loss of a spouse, money, loneliness, a decrease in physical health, and family illness. Conclusion. The results from the study support the positive effect of occupation-based programming on social participation in community-dwelling older adults. In achieving good quality of life while aging, it is important to maintain relationships with family and friends, and finding time to support and help others in need.