TY - JOUR
T1 - Psychological Resilience in Older Residents of Long-Term Care Facilities
T2 - Occurrence and Associated Factors
AU - Angevaare, Milou J.
AU - Joling, Karlijn J.
AU - Smalbrugge, Martin
AU - Choi, Hyoungshim
AU - Twisk, Jos W. R.
AU - Hertogh, Cees M. P. M.
AU - van Hout, Hein P. J.
N1 - Funding Information: This work was supported by Amsterdam UMC , Amsterdam, the Netherlands. Publisher Copyright: © 2022 The Authors
PY - 2023/3
Y1 - 2023/3
N2 - Objectives: The researchers aimed to (1) explore the occurrence of psychological resilience in the face of a major life stressor and conflict in older residents of long-term care facilities (LTCFs), and (2) identify factors associated with resilience in this population. Design: Longitudinal cohort study using the Dutch InterRAI-LTCF cohort. Setting and participants: Older residents (≥60 years old) of 21 LTCFs in the Netherlands. Methods: The researchers selected 2 samples of residents who had at least 2 assessments surrounding (1) an incident major life stressor, or (2) incident conflict with other resident or staff. A resilient outcome was operationalized as not having clinically meaningful mood symptoms at the post-stressor assessment and equal or fewer mood symptoms at the post-stressor relative to the pre-stressor assessment. The researchers used 2 resilience outcomes per stressor: 1 based on observer-reported mood symptoms and 1 based on self-reported mood symptoms. The most important factors from among 21 potential resilience factors for each of the 4 operationalizations of resilience were identified using a backward selection procedure with 2-level generalized estimating equations analyses. Results: Forty-eight percent and 50% of residents were resilient in the face of a major life stressor, based on observer-reported (n = 248) and self-reported (n = 211) mood, respectively. In the face of conflict, 26% and 51% of the residents demonstrated resilience, based on the observer-reported (n = 246) and self-reported (n = 183) mood, respectively. Better cognitive functioning, a strong and supportive relationship with family, participation in social activities, and better self-reported health were most strongly associated with resilience in the face of a major life stressor. Better communicative functioning, absence of psychiatric diagnoses, a strong and supportive relationship with family, not being lonely, social engagement, and not reminiscing about life were most strongly associated with resilience in the face of conflict. Conclusions and Implications: Factors with a social aspect appear to be particularly important to psychological resilience in older LTCF residents, and provide a potential target for intervention in the LTCF setting.
AB - Objectives: The researchers aimed to (1) explore the occurrence of psychological resilience in the face of a major life stressor and conflict in older residents of long-term care facilities (LTCFs), and (2) identify factors associated with resilience in this population. Design: Longitudinal cohort study using the Dutch InterRAI-LTCF cohort. Setting and participants: Older residents (≥60 years old) of 21 LTCFs in the Netherlands. Methods: The researchers selected 2 samples of residents who had at least 2 assessments surrounding (1) an incident major life stressor, or (2) incident conflict with other resident or staff. A resilient outcome was operationalized as not having clinically meaningful mood symptoms at the post-stressor assessment and equal or fewer mood symptoms at the post-stressor relative to the pre-stressor assessment. The researchers used 2 resilience outcomes per stressor: 1 based on observer-reported mood symptoms and 1 based on self-reported mood symptoms. The most important factors from among 21 potential resilience factors for each of the 4 operationalizations of resilience were identified using a backward selection procedure with 2-level generalized estimating equations analyses. Results: Forty-eight percent and 50% of residents were resilient in the face of a major life stressor, based on observer-reported (n = 248) and self-reported (n = 211) mood, respectively. In the face of conflict, 26% and 51% of the residents demonstrated resilience, based on the observer-reported (n = 246) and self-reported (n = 183) mood, respectively. Better cognitive functioning, a strong and supportive relationship with family, participation in social activities, and better self-reported health were most strongly associated with resilience in the face of a major life stressor. Better communicative functioning, absence of psychiatric diagnoses, a strong and supportive relationship with family, not being lonely, social engagement, and not reminiscing about life were most strongly associated with resilience in the face of conflict. Conclusions and Implications: Factors with a social aspect appear to be particularly important to psychological resilience in older LTCF residents, and provide a potential target for intervention in the LTCF setting.
KW - LTCF
KW - conflict
KW - interRAI
KW - major life stressor
KW - older adults
KW - operationalization
KW - resilience factors
UR - http://www.scopus.com/inward/record.url?scp=85146085337&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jamda.2022.12.006
DO - https://doi.org/10.1016/j.jamda.2022.12.006
M3 - Article
C2 - 36592940
SN - 1525-8610
VL - 24
SP - 382-389.e4
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 3
ER -