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Promoting social activities and participation among seniors: exploring and evaluating social and Internet-based occupational therapy interventions
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Occupational Therapy.
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction

The use of technology and Internet-based activities (IBAs) is increasing in society. However, seniors with limited experiences with the Internet can experience restricted participation in meaningful activities that are dependent on the Internet. Also, social transitions during aging might lead to reduced social activities and social contacts and to increased experiences of loneliness, all of which might have negative health implications. Therefore, there is a need to advance the knowledge of how occupational therapists can support seniors’ use of IBAs and create opportunities for social contacts and social activities during aging.

Aim

The overall aim of this thesis is to increase the knowledge of how Internet-based activities influence seniors’ participation in society, how seniors experience and are influenced by support from a social Internet-based occupational therapy intervention, and how different aspects of this intervention can contribute to healthy ageing.

Methods

In study I, seniors’ experiences of IBAs were explored and described through interviews with 10 seniors (66–82 years old) that were analyzed with the constant comparative method. In study II, a multiple case study with five seniors (65–85 years old) was used to explore the design of an Internet-based occupational therapy social intervention program and how it influenced social activities and social contacts among the participants. The qualitative and quantitative data from multiple sources were analyzed by pattern matching. In study III, an explorative randomized crossover study with an AB/BA design was conducted with 30 seniors (61–89 years old) who were vulnerable to loneliness and who participated in the intervention program. The quantitative data were analyzed with parametric and non-parametric statistics. In study IV, a qualitative interview study was conducted to collect the experiences of 15 seniors (66–87 years old) from the previous intervention process in study III. The interviews were analyzed with the constant comparative method. All participants in studies I–IV were community-dwelling, retired seniors without home-care services.

 

Results

Complex interactions of different aspects influence seniors’ possibilities and preferences for taking part in IBAs. The performance of IBAs yielded different experiences of participation in society (study I). The initial explorative results indicated that the client-centered and individually adapted intervention program supports participation in social IBAs (SIBAs) and other social contexts (study II). After participation in the intervention program, the experiences of loneliness significantly decreased, and satisfaction with social contacts on the Internet increased for one group (study III). If an individual’s requirements are met during the intervention process, experiences of habitual SIBA usage, increased self-reliance, and enriched social contacts and social activities both on and off the Internet might be facilitated (study IV).

Conclusion

This thesis provides knowledge of how social support, experiences of and accessibility to technology, life-changing events, and identified meaningfulness with online activities influence the motivation to participate in social and Internet-based activities. The occupational therapist should address the individual’s perspective in the intervention program so as to adapt the intervention and to support experiences of satisfactory participation and enhanced social activities and social contacts for seniors. In addition, healthy aging might be supported by the intervention program due to the reduction in loneliness and increased participation in social activities and society. Further evaluation of the framework and content of the intervention program for seniors with restricted participation in IBAs and SIBAs and high levels of loneliness is suggested.

Place, publisher, year, edition, pages
Umeå: Umeå University , 2016. , p. 90
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1765
Keywords [en]
Health promotion, social activities, social media, evidence-based practice
National Category
Occupational Therapy
Identifiers
URN: urn:nbn:se:umu:diva-114436ISBN: 978-91-7601-388-5 (print)OAI: oai:DiVA.org:umu-114436DiVA, id: diva2:895372
Public defence
2016-02-12, Aulan, Vårdvetarhuset, Umeå Universitet, 90187 Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2016-01-22 Created: 2016-01-18 Last updated: 2018-06-07Bibliographically approved
List of papers
1. Internet Based Activities (IBAs): Seniors' experiences of the conditions required for the performance of and the influence of these conditions on their own participation in society
Open this publication in new window or tab >>Internet Based Activities (IBAs): Seniors' experiences of the conditions required for the performance of and the influence of these conditions on their own participation in society
2013 (English)In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 39, no 3, p. 155-167Article in journal (Refereed) Published
Abstract [en]

The digital gap is a threat to the participation of senior citizens in society, as a large proportion of seniors are not involved in Internet based activities (IBAs). To be able to overcome this disadvantage for seniors, there is a need to both learn more about the conditions that make seniors start performing IBAs and to be able to provide them with the most beneficial professional interventions. The aim of this study was to explore and describe seniors' experiences with IBAs. Qualitative interviews were conducted with 10 seniors (aged: 66-82 years) with a variety of experiences with IBAs, and the interviews were analyzed with the constant comparative method. The results reveal three categories that describe the experiences of the established performers, the new performers of IBAs in the process of starting out, and the nonperformers. The variations in performance were influenced by the meaning that the performance of IBAs had for the seniors. In addition, the seniors were affected by several other conditionssuch as the support available in their environment, including access to knowledgeas this could encourage them to develop their performance. Basic aspects, such as having access to a computer and to the Internet had been arranged for the performers of IBAs. The different ways of performing IBAs, revealed in the three categories, influenced how the seniors viewed their opportunities to participate in society. The conclusion highlights the finding that professionals should consider a multitude of conditions when introducing seniors to the performance of meaningful IBAs.

National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-65275 (URN)10.1080/03601277.2012.699833 (DOI)000323500500002 ()2-s2.0-84872553579 (Scopus ID)
External cooperation:
Available from: 2013-02-06 Created: 2013-02-06 Last updated: 2023-03-24Bibliographically approved
2. Participation in social internet-based activities: five seniors' intervention processes
Open this publication in new window or tab >>Participation in social internet-based activities: five seniors' intervention processes
2013 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 6, p. 471-480Article in journal (Refereed) Published
Abstract [en]

Objective: To explore how client-centred occupational therapy intervention processes for participation in meaningful Social Internet-Based Activities (SIBAs) can be designed, and to explore the influences of participation in SIBAs on seniors' social activities and social contacts. Method: A qualitative, descriptive, multiple-case study was conducted, and an intervention was provided to the five participants, who were aged 65-85. Data were collected through assessment tools, field notes, and interviews. Results: The participants' needs and challenges related to SIBAs varied during the intervention processes. Individual-adapted support was provided for the seniors (by the occupational therapist) to managing the introduction to different SIBAs, their appearance on the internet, and the lack of privacy. The association between the seniors' participation in SIBAs and their satisfaction with these activities, as well as their social contacts, requires further exploration. Conclusions: Client-centred occupational therapy interventions can support seniors' participation in SIBAs and their self-reliance when performing these activities.

Place, publisher, year, edition, pages
London: Informa Healthcare, 2013
Keywords
multiple case study, individual-adapted support, client-centred
National Category
Occupational Therapy
Identifiers
urn:nbn:se:umu:diva-85567 (URN)10.3109/11038128.2013.839001 (DOI)000328280300009 ()24074300 (PubMedID)2-s2.0-84886795975 (Scopus ID)
Funder
EU, European Research CouncilSwedish Research Council, 2006-21576-36119-66
Available from: 2014-02-07 Created: 2014-02-06 Last updated: 2018-08-28Bibliographically approved
3. Effects of a social Internet-based intervention programme for older adults: An explorative randomized crossover study
Open this publication in new window or tab >>Effects of a social Internet-based intervention programme for older adults: An explorative randomized crossover study
2016 (English)In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 10, p. 629-636Article in journal (Refereed) Published
Abstract [en]

Introduction: Restraints and changes in social activities might contribute to loneliness and health decline for older adults. To reduce loneliness and support activities, social internet-based interventions are indicated to be effective. The aim of this study was to evaluate the effects of a social internet-based intervention for older adults who are vulnerable to loneliness.

Method: An explorative, randomised, crossover study with an AB/BA sequence was completed. The intervention was conducted over a period of three months. Thirty participants were included (24 women and six men, 61-89 years old) and allocated to two groups. Data were collected at three time points. The primary outcome was the UCLA loneliness scale, and the secondary outcomes were satisfaction with social contacts and social interaction skills. Statistical analyses were conducted with the paired t-test, Wilcoxon's signed-rank test and repeated-measures analysis of variance.

Results: Loneliness was significantly decreased in both groups post intervention, and satisfaction with social contacts online significantly increased in one group. Significant treatment effects were detected for all outcomes.

Conclusion: The results of the social internet-based intervention programme are promising, but further evaluations are needed

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
Loneliness, social activities, social contacts
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-114429 (URN)10.1177/0308022616641701 (DOI)000385810800008 ()2-s2.0-84991746940 (Scopus ID)
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2023-03-24Bibliographically approved
4. Developing social contact and participation in social activities: Seniors experiences from a social Internet-based intervention process
Open this publication in new window or tab >>Developing social contact and participation in social activities: Seniors experiences from a social Internet-based intervention process
2017 (English)In: Gerontechnology, ISSN 1569-1101, E-ISSN 1569-111X, Vol. 16, no 2, p. 101-108Article in journal (Refereed) Published
Abstract [en]

Objective: To explore seniors’ experiences of the intervention process after participating in a social internet-based occupational therapy intervention.

Method: A qualitative interview study was conducted. Twelve women and 3 men (66–87 years old), from the completed intervention study participated. The study was placed in northern Sweden. Data were collected through semi-structured interviews. The interviews were analyzed using the constant comparative method, and two categories with subcategories were generated in the analysis.

Results: The seniors experienced a need to participate in social internet-based activities (SIBAs) due to their decline in social activities and the ever-increasing digitalization of society. In the intervention process, the seniors’ experiences reflected two divergent directions. The first consisted of seniors who had experiences of being hampered in participating in the SIBAs in the intervention process. They did not completely reach their intervention goals, but they did describe increased ability to use SIBAs and increased self-reliance. The other direction of the process reflected experiences of reaching their goals in the intervention, and they developed habitual participation in SIBAs as well as increased participation in social activities outside the Internet.

Conclusion: The social internet-based intervention can support seniors to overcome the obstacles that prevent them from participating in SIBAs. By participating in SIBAs, the seniors might enrich their social activities and social contacts both on the Internet and outside, if the intervention is individually targeted to meet their needs.

Place, publisher, year, edition, pages
the International Society for Gerontechnology, 2017
Keywords
Loneliness, occupational therapy, social media, social activities, internet-based intervention, seniors, social contacts
National Category
Occupational Therapy
Research subject
Occupational therapy
Identifiers
urn:nbn:se:umu:diva-114432 (URN)10.4017/gt.2017.16.2.005.00 (DOI)2-s2.0-85038366570 (Scopus ID)
Available from: 2016-01-18 Created: 2016-01-18 Last updated: 2023-03-23Bibliographically approved

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