| Summary: | 博士 === 國立臺北護理健康大學 === 護理研究所 === 106 === Abstract
Background: Sarcopenia is an important factor affecting the health status for the geriatric population, and the proportion of elderly people suffering from chronic diseases is relatively high. The study of the psychology and leisure activity of elderly patients with sarcopenia combined with heart disease is insufficient. There is insufficient evidence for the findings of changes in mental state and leisure activity. Therefore, the relationship between resilience and leisure activity of this ethnic group and long-term trajectory trends are explored.
Purpose: To examine the relationship between resilience and leisure activity in elderly people with sarcopenia combined with heart disease and change long-term trajectory. The first stage of the research project (systematic literature review phrase):review of resilience and leisure activity literature reviewing results, the second stage of the research project (long-term trajectory): tracking longitudinal tracking studies, detection of longitudinal data tracking for resilience and leisure activity in different time points.
Method: This study is a two-stage research project. The first stage is the review and analysis of systematic literature, and analyzes the related variables of physical activity and resilience of elderly people in the databases. The second stage of research is the long-term trajectory study. The number of 96 samples was collected at the first outpatient (baseline) after the case was collected. Data collection included analysis of demographics data, resilience, leisure activity, and other variables, and the detection of longitudinal data at different time points (three and six months). Six months later, we discussed the changes of psychological indicators (psychological resilience) and physical activities (leisure activities) in elderly patients with sarcopenia combined with heart disease.
Results: The first stage of the study: the review of literature found that physical activity intervention has significant improvement in muscle mass, walking speed, or grip strength for elderly people, and intervention plan include at least two types of exercises, however, the type of exercise, intensity, and duration were no consistency in each research. Besides, the tools for examining the effectiveness after interventions lack of consistency and standardization. The second stage of the study: The subjects of this study were older than 65 years old, more males than females, married, living with family members, education in senior high school, belief in Buddhism, exercise time less than 30 minutes per each time. Chronic diseases are mainly heart diseases and hypertension. The state of resilience was significantly different from gender (p=.02), age (p=.03), and self-care (p<.01). There were significant differences between leisure activity and age (p = .01), significant differences with education (p = .02), and family income and exercise time (p = .01, p < .01). There was a positive correlation between resilience and leisure activity (r=.42, p<.01), and the level of resilience was predictive of the participation rate of leisure activities, with significant significance (p=0.00). The model could explain the overall situation. The total variation of leisure activities reached 17.3%. The resilience and leisure activity gradually increased at different time points (baseline, 3 months, and 6 months) across the long-term trajectory. In the Group-Based trajectory analysis, the second group of patients after clustering four groups showed significant differences in the resilience of the second group of subjects under control variables of age, gender, and self-care (Β = 4.2, SE = 1.46, p<0.00), showing that there is a significant increase in resilience; the first group of leisure activities changes with time, their frequency of participation in leisure activities increased significantly; and leisure activities in the first group of research objects show significant differences (Β =2.7, SE = 1.24, p = 0.03), indicating a significant increase in leisure activities
Conclusion: The results of the study confirm that resilience and leisure activities play an important role in the elderly patients with sarcopenia combined with heart disease. The psychological state of the elderly will affect the frequency of their participation in physical (leisure) activities, and for patients with sarcopenia. It is benefit for elder people to prevent disability, falls, or loss of self-care ability due to sarcopenia. In the ageing society in Taiwan, the psychological statues and the ability to adjust chronic are important factors for older people. We can encourage them to take part in appropriate leisure activities in order to increase physical activity and promote mental health.
Clinical and Practical Applications: The results of this study focus on patients with sarcopenia combined with heart disease, as well as to explore the long-term changes in resilience and physical activity in individual. It is help for clinical staff to design intervention to improve the nursing care quality, which in advance to lower medical costs and the occurrence of sarcopenia, thereby improving the quality of life for elderly people and promoting successful aging.
Key words: Resilience, Physical activity, Leisure activity, Sarcopenia, geriatric population, heart disease
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