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Adaptation to Aging Model. Stimuli. Adaptation Modes. Behavioral Output. Outcome. Physiologic Physical function Role Function ADLs Self-Concept Spirituality Confidence to exercise Interdependence Relationships with family . ↓ TUG ↑ HAQ-DI ↑ SWBS

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slide1

Adaptation to Aging Model

Stimuli

Adaptation Modes

Behavioral Output

Outcome

  • Physiologic
  • Physical function
  • Role Function
  • ADLs
  • Self-Concept
  • Spirituality
  • Confidence
  • to exercise
  • Interdependence
  • Relationships
  • with family

↓ TUG

↑ HAQ-DI

↑ SWBS

One item question

↑ SF-36 Question 6

Quality of Life

↑ FACIT-Sp

Version-4

Sign Chi Do Exercise

Sign Chi Do Exercise for Adaptation to Aging

Carol Rogers, MSN, APRN-BC Anna Schwartz, PhD

  • Background
  • The population of older adults in Arizona increased 10% between 1990 and 2000 and is expected to increase 60% by 2050
  • Preventable conditions among the top 10 causes of death and disability reported in 2003 were diseases of the heart, cerebrovascular diseases, diabetes, and unintentional injuries (mostly falls)
  • In 2005, 47% of people 65 to 74 and 60% over 75 years of age reported sedentary lifestyle
  • $150 billion: the cost of healthcare related to chronic conditions as a result of sedentary lifestyle
  • Exercise improves physical function, adaptation, and quality of life (QOL)
  • Sedentary lifestyle results in disuse consequences, compromised adaptation, and poorer QOL among community dwelling adults ≥ 65 years of age
  • Previous studies have not included the recruitment of Hispanic population required for generalization to the population in Arizona
  • No research has examined a mind-body intervention to improve QOL in older adults
  • Significance
  • Aging adults face multiple challenges in adaptation and related QOL
  • Research demonstrated physical activity is an important component of successful adaptation and QOL among older adults
  • Mind-body exercise may be beneficial to adaptation and QOL
  • There has been limited research of mind-body exercise interventions to promote adaptation in the population of aging adults
  • The proposed pilot project will focus on the evaluation of the efficacy of a mind-body intervention (SCD exercise) to promote adaptation and QOL among sedentary community dwelling adults 65 years and older
  • Methods
  • Determine the efficacy of a theory-based intervention to improve adaptation and QOL among sedentary community dwelling older adults
    • Design: A randomized experimental design with repeated measures will be used to test the efficacy of the intervention
    • Sample: N = 60 sedentary adults over 65 years of age
    • Setting: Community Senior Center in Arizona
    • Procedures: Following IRB approval, eligible subjects will sign informed consent and be randomized to SCD or Wait-list Control group. Data collection will occur at baseline, 12 weeks, and 6 months
    • Intervention Structure:
      • 1 hour SCD class X 12 weeks
      • 30 minutes SCD home-based exercise 3-5 days per week X 12 weeks
      • Each session includes a 5 minute warm up and cool down with 50 minutes of instruction and practice of SCD
    • Measures: Measures at baseline, 12 weeks, and 6 months
      • Physiologic: Physical function measured by Timed Up & Go (TUG)
      • Role Function: Activities of Daily Living measured by Disability Index of Health Assessment Questionnaire (HAQ-DI)
      • Self-Concept: Spirituality measured by Spiritual Well Being Scale (SWBS) and confidence to perform SCD by one item question
      • Interdependence: relationships with family measured by SF-36 Question 6
      • Quality of Life: measured by Functional Assessment of Chronic Illness Therapy
    • Data Management and Analysis: Coded data collection forms will be completed and reviewed at each measurement time
      • Aim 1: ANOVA
      • Aim 2: ANOVA
      • Aim 3: Cohen’s d
  • Theoretical Perspective for Adaptation to Aging
  • Guided by Roy’s Adaptation Model:
    • Humans are holistic, dynamic, adaptive systems, interacting with the environment
    • Adaptation is a process and outcome of making conscious awareness and choice
    • Adaptation is described in three levels: integrated (well adjusted), compensatory (attempts to re-establish integration occur) or compromised (compensatory process not adequate)
    • Adaptation is measured in four modes: physiologic, role model, self-concept, and interdependence
  • Implications
  • Determine if a mind, body, spiritual exercise intervention improves adaptation to aging and QOL among sedentary older adults
  • Inclusion of Hispanic population may provide evidence of culturally appropriate intervention for the state of Arizona
  • Promote the NINR mission to improve health and QOL with a community-based approach
  • Develop a program of research testing effective strategies to promote QOL

Previous Study

Evaluation of effect of Sign Chi Do (SCD) class on balance, physical activity, and satisfaction among adults (N=22) over 50 yo

Study group was 68% White and 18% Hispanic

No significant change in Timed Up & Go from pre to post [t20)=0.87, p>.05)]

Significant change in Seven Day Physical Activity Recall [t(19)=-3.01,p<.05]

85% reported enjoyed the class and 79% would take the class again

Specific Aims

Aim 1. Evaluate the efficacy of SCD exercise compared to Attention Control group on the theoretical mediating variables of adaptation among sedentary community dwelling adults ≥ 65 years of age at baseline, 12 weeks, and 6 months

Aim 2. Evaluate the efficacy of SCD compared to an Attention Control group on QOL

Aim 3. Determine the effect size of SCD on QOL