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Development and Peer Review of an Evidence-Based Decision-Support Tool for Non-Drug Prescribing for Healthy Ageing 健康老龄化非药物处方循证决策支持工具的开发与同行评议
Pub Date : 2023-03-31 DOI: 10.3390/jal3020010
Zara Quail, M. Carter, Charles Young
Introduction: Promoting healthy ageing is increasingly important to maintain functional ability and wellbeing in older age. However, there is a lack of consolidated evidence-based information to support the selection of non-drug interventions to support healthy ageing outcomes for individuals. Methods: A narrative review of the evidence-based literature on non-drug interventions to support healthy ageing was performed. Evidence for intervention benefits was evaluated and mapped into the Systematic Wellness Intervention Pathway framework and aligned to relevant goals, needs and outcomes relating to physical fitness and function, emotional wellbeing, cognitive health, sleep and diet and nutrition. Comments from a modified Delphi survey of 75 expert peer reviewers were analysed to inform the development of the next Pathway iteration. Results: The narrative review identified key healthy ageing interventions, including physical activity, social interaction, interventions for emotional wellbeing, creative and cognitively stimulating activities and diet and nutrition. Peer review survey results indicated majority agreement with all domains and non-drug interventions for healthy ageing in the Pathway, and suggested interventions and outcome revisions informed Pathway iteration. Conclusion: The Pathway could be a step forward in operationalising the delivery of non-drug interventions in an accessible and scalable way, supplementing conventional health and social care, to enable older people to live well for longer.
引言:促进健康老龄化对于保持老年人的功能能力和健康越来越重要。然而,缺乏综合的循证信息来支持选择非药物干预措施来支持个人的健康老龄化结果。方法:对支持健康老龄化的非药物干预的循证文献进行叙述性综述。对干预益处的证据进行了评估,并将其纳入系统健康干预途径框架,并与身体健康和功能、情绪健康、认知健康、睡眠、饮食和营养相关的相关目标、需求和结果相一致。分析了对75名专家同行评审员进行的修改后的德尔菲调查的意见,为下一次Pathway迭代的开发提供信息。结果:叙述性综述确定了关键的健康老龄化干预措施,包括体育活动、社交、情绪健康干预、创造性和认知刺激活动以及饮食和营养。同行评审调查结果表明,大多数人同意路径中针对健康老龄化的所有领域和非药物干预措施,并建议干预措施和结果修订为路径迭代提供信息。结论:该途径可以在以可获得和可扩展的方式实施非药物干预方面向前迈出一步,补充传统的卫生和社会护理,使老年人能够活得更长。
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引用次数: 0
“The Ark of Rights”: Development of a Board Game to Empower Older Adults Regarding Their Rights “权利方舟”:开发棋盘游戏,赋予老年人权利
Pub Date : 2023-03-17 DOI: 10.3390/jal3010009
C. Fernandes, Camila Neto, Catarina Silva, Sara Dionísio, Susana Oliveira, Isabel Amorim, Alice Delerue Matos, Maria Manuela Martins
There is an urgent need to ensure the rights of older adults. In particular, there is a lack of awareness of human rights by older adults themselves, for which intervention strategies should be developed. Due to the need for intervention at this level, a board game was created to empower older adults regarding their rights using a dynamic and interactive method. This article aims to describe the development stages of the board game “The Ark of Rights”® up to its pilot study. Its development followed three stages: A first phase to review the scientific literature and benchmarks on the rights of older persons, a second phase to define the game design and collect statements from older people for the game, and a third phase to test the game. The European Portuguese Validation of the System Usability Scale (SUS) was used to assess the latter phase. Approximately 200 older people contributed to the game’s contents (second phase), and 74 participated and positively evaluated the game’s usability and their satisfaction with its use (third phase). In summary, the game “The Ark of Rights” revealed itself to be a resource for empowering older adults regarding their rights. It also enables the identification of possible human rights violations among older adults and subsequent intervention.
迫切需要确保老年人的权利。特别是,老年人本身缺乏对人权的认识,为此应制定干预战略。由于需要在这一层面进行干预,创建了一个棋盘游戏,以使用动态和互动的方法增强老年人的权利。本文旨在描述棋盘游戏“权利方舟”®的开发阶段,直至其试点研究。它的开发经历了三个阶段:第一阶段审查关于老年人权利的科学文献和基准,第二阶段定义游戏设计并收集老年人对游戏的陈述,第三阶段测试游戏。使用欧洲-葡萄牙系统可用性量表(SUS)对后一阶段进行评估。大约200名老年人为游戏内容做出了贡献(第二阶段),74人参与并积极评价了游戏的可用性和他们对游戏使用的满意度(第三阶段)。总之,“权利方舟”游戏本身就是一种赋予老年人权利的资源。它还能够识别老年人中可能存在的侵犯人权行为,并进行后续干预。
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引用次数: 0
Heart rate variability in people with metabolic syndrome 代谢综合征患者的心率变异性
Pub Date : 2023-03-06 DOI: 10.47855/jal9020-2023-1-1
Kostiantyn Apykhtin, Svitlana Drozdovska, Olha Hurenko, Anastasiia Nahorna, Anatoly Pisaruk, Yuliia Panchenko, Olena Andrieieva
Metabolic syndrome (MS) is characterized by disorders of carbohydrate and fat metabolism, which can lead to the development of cardiac autonomic neuropathy (CAN). Heart rate variability (HRV) analysis is used to assess the state of autonomic regulation. A decrease in HRV indicates unfavourable changes in autonomic regulation and the development of CAN. The purpose of this study was to compare HRV parameters in patients with metabolic syndrome and healthy individuals without signs of MS. We examined 74 patients with metabolic syndrome (mean age 54.4 ± 1.1 years) and 61 healthy subjects (without signs of MS) (mean age 57.0 ± 1.6 years). The results of the study indicate a significant decrease in HRV in people with MS. However, they had significantly lower values of the SDNN index (by 26%), which characterizes the overall power of neurohumoral regulation of heart rate. Differences in the indicators characterizing short-term, vagal influences were especially pronounced: in patients with MS, RMSSD (by 44%) and HF (by 69%) were lower than in controls. The activity of the baroreflex center of the medulla oblongata, assessed by the spectral power of low-frequency waves (LF), was 55% lower in patients with MS compared to controls. There were no significant differences in the mean duration of the R-R interval, the spectral power of very low frequency (VLF) waves, or the ratio of the spectral powers of low and high frequencies (LF/HF, LFn, HFn) in patients with MS compared to controls. No significant shift in the autonomic balance towards sympathicotonia was found in patients with MS. The analysis of variance confirmed the significant effect of the metabolic syndrome factor on HRV. Thus, the data obtained indicate the development of CAN in people with metabolic syndrome, which is an unfavourable prognostic sign. To assess the effect of MS on the rate of aging, the biological age (BA) of the examined people with MS was calculated. The formula for calculating BA was obtained on a group of people without MS. The method of multiple stepwise regression was used. The aging rate was calculated as the difference between biological and chronological age (CA). The average BA in the group of people with MS was 63,20 ± 1,81 years, in the control group – 53.99 ± 1.71 years (p< 0.05). The difference between BA and CA is 8,81 ± 0,94 years in the group of people with MS and -1.01 ± 0.61 in control group (p< 0.05). From this we can conclude that MS can be a factor accelerating aging. _________________________________________________________________________________________ Keywords: metabolic syndrome, heart rate variability, biological age
代谢综合征(MS)以碳水化合物和脂肪代谢紊乱为特征,可导致心脏自主神经病变(can)的发展。心率变异性(HRV)分析用于评估自主调节状态。HRV的下降表明自主调节和CAN的发展发生了不利的变化。本研究的目的是比较代谢综合征患者和无MS体征的健康人的HRV参数。我们检查了74例代谢综合征患者(平均年龄54.4±1.1岁)和61例健康受试者(平均年龄57.0±1.6岁)。研究结果表明,ms患者的HRV显著降低,但他们的SDNN指数显著降低(26%),该指数表征了神经体液调节心率的总体能力。表征短期迷走神经影响的指标差异尤其明显:在MS患者中,RMSSD(减少44%)和HF(减少69%)低于对照组。通过低频波(LF)的频谱功率评估,MS患者的延髓压力反射中心的活动比对照组低55%。MS患者R-R间隔的平均持续时间、甚低频(VLF)波的频谱功率、低频与高频(LF/HF、LFn、HFn)频谱功率之比与对照组相比无显著差异。ms患者自主神经平衡向交感张力方向未见明显变化,方差分析证实代谢综合征因素对HRV有显著影响。因此,获得的数据表明,在代谢综合征患者中CAN的发展,这是一个不利的预后迹象。为了评估多发性硬化症对衰老速度的影响,我们计算了多发性硬化症患者的生物年龄(BA)。采用多元逐步回归的方法,对未患多发性硬化症的人群进行分析,得到BA的计算公式。衰老率计算为生物年龄和实足年龄(CA)之差。MS组平均BA为63,20±1,81年,对照组平均BA为- 53.99±1.71年(p < 0.05);0.05)。MS组BA与CA的差异为8.81±0.94年,对照组BA与CA的差异为-1.01±0.61年(p < 0.05);0.05)。由此我们可以得出结论,多发性硬化症可能是加速衰老的一个因素。_________________________________________________________________________________________ 关键词:代谢综合征、心率变异性、生物年龄
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引用次数: 0
Religious Bodies–Lutheran Chaplains Interpreting and Asserting Religiousness of People with Severe Dementia in Finnish Nursing Homes 宗教团体-路德会牧师对芬兰养老院中患有严重痴呆症的人的宗教信仰的解释和断言
Pub Date : 2023-03-02 DOI: 10.3390/jal3010008
Jari Pirhonen, A. Vähäkangas, S. Saarelainen
The prevalence of dementia is increasing globally as populations grow older. Moderate and severe dementia are the main reasons for older people entering long-term care in Finland, and the vast majority of nursing home residents have it. Regarding mild dementia, religiousness is known to slow the progress of the disease, offer solace, and maintain a life-long identity. However, we know practically nothing about the religiousness of people with severe dementia. This study sought to fill the gap by interviewing Lutheran chaplains working in Finnish nursing homes. The data were subjected to qualitative content analysis to understand: (I) how people with severe dementia may express their remaining religiousness and (II) how the chaplains asserted the religiousness of people whom their words often did not reach. The clearest expressions of religiousness found were bodily, including expressions of emotions and fumbling liturgical movements. The chaplains utilized prayer services, active presence, and generational intelligence to respond to residents’ religiousness. The main conclusion is that people with severe dementia can express their faith and are eager to practice it when opportunities are provided to do so. Our research challenges care providers and religious communities to better acknowledge the religiousness of people with severe dementia.
随着人口老龄化,痴呆症的患病率在全球范围内呈上升趋势。中度和重度痴呆症是芬兰老年人进入长期护理的主要原因,绝大多数养老院的居民都患有痴呆症。对于轻度痴呆症,宗教信仰可以减缓疾病的进展,提供安慰,并保持一生的身份。然而,我们实际上对患有严重痴呆症的人的宗教信仰一无所知。本研究试图通过采访在芬兰养老院工作的路德教会牧师来填补这一空白。对这些数据进行定性内容分析,以了解:(I)严重痴呆症患者如何表达他们剩余的宗教信仰;(II)牧师如何断言他们的话往往无法达到的人的宗教信仰。最明显的宗教表达是身体上的,包括情感的表达和笨拙的礼拜动作。牧师利用祈祷服务、积极在场和世代智慧来回应居民的宗教信仰。主要结论是,患有严重痴呆症的人可以表达他们的信仰,并渴望在有机会的时候这样做。我们的研究要求护理人员和宗教团体更好地承认患有严重痴呆症的人的宗教信仰。
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引用次数: 0
Acknowledgment to the Reviewers of Journal of Ageing and Longevity in 2022 感谢《老龄化与长寿杂志》2022年审稿人
Pub Date : 2023-02-08 DOI: 10.3390/jal3010007
High-quality academic publishing is built on rigorous peer review [...]
高质量的学术出版建立在严格的同行评审的基础上[…]
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引用次数: 0
Planning for Aging and Frailty: A Qualitative Study on Older Adults’ Perceptions, Facilitators, and Barriers 老龄化和脆弱性规划:老年人认知、促进者和障碍的定性研究
Pub Date : 2023-02-02 DOI: 10.3390/jal3010006
Erica Frechman, Harleah G. Buck, M. Dietrich, B. Rhoten, A. Davis, Cathy A. Maxwell
Aging is often accompanied by health events that may disrupt older adults’ desires to age in place. Understanding older adults’ perceptions of planning for their aging process was a priority to identify how planning behaviors occur. Our study explored how people perceive the concept of planning for aging and frailty, and identified the facilitators and barriers involved in the planning process. Using conventional qualitative content analysis, we used the data from semi-structured interviews of twenty community-dwelling older adults aged 50–80 years old. Demographic information was obtained, followed by the participant interviews. Seventeen code categories surfaced including six categories in the perception domain (i.e., internal, external, and future-oriented), seven categories in the facilitators domain (i.e., internal, external, and systems), and four categories in the barriers domain (i.e., internal, and systems). The emergent categories included understanding one’s perception of planning through a holistic lens, the importance of experiences with self/others as facilitators, and the physical/cognitive/emotional factors that serve as barriers within a larger sphere of societal influence. Planning for aging and frailty is an innovative concept that normalizes the aging process and promotes planning through an awareness of aging across the life-course domains. Future research is warranted for intervention development to help older adults recognize and actively plan for aging and to address the barriers involved.
衰老通常伴随着健康事件,这些事件可能会破坏老年人就地衰老的愿望。了解老年人对衰老过程规划的看法是确定规划行为如何发生的首要任务。我们的研究探讨了人们如何看待衰老和虚弱的规划概念,并确定了规划过程中涉及的推动者和障碍。使用传统的定性内容分析,我们使用了20名50-80岁社区老年人的半结构化访谈数据。获得人口统计信息,然后对参与者进行访谈。17个代码类别浮出水面,包括感知领域的6个类别(即内部、外部和面向未来),促进者领域的7个类别(如内部、外部、系统),以及障碍领域的4个类别(例如内部和系统)。新兴类别包括通过整体视角理解一个人对计划的看法,将自我/他人作为促进者的经历的重要性,以及在更大的社会影响范围内作为障碍的身体/认知/情感因素。针对衰老和虚弱的规划是一个创新概念,它使衰老过程正常化,并通过对整个生命过程领域的衰老意识来促进规划。未来的研究需要制定干预措施,以帮助老年人认识到并积极规划老龄化,并解决相关障碍。
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引用次数: 0
How Families’ Use of Digital Technology Can Be a Tool for Reducing Loneliness and Improving Food Intake among Older Adults 家庭对数字技术的使用如何成为老年人减少孤独感和改善食物摄入量的工具
Pub Date : 2023-01-25 DOI: 10.3390/jal3010004
I. S. Grini, Ø. Ueland
The purpose of this study was to explore how a technical solution implemented among older adults and connected with an app supervised by an app administrator can reduce loneliness, prevent malnutrition, and inspire social eating and networking. In October 2020, a survey was distributed to 3500 administrators of the one-button computer communication tool Komp. Komp consists of a screen placed with older adults and an app used by the administrator of the tool. The survey addresses aspects that can provide new insights into how older adults can use digital solutions as a link to family and external networks. The study results show that due to COVID-19, 65% of respondents said they used Komp more frequently than before, but only 5% of current use was associated with eating meals together. However, 54% of the app administrators indicated that this could be a good future activity. Furthermore, 88% thought Komp could contribute to more socializing through shared meals. This study elicited almost 1650 constructive comments on experience, use, and recommendations. The study results show that digital solutions can be a link between older adults and their families and external network. Such tools can address needs connected to loneliness, social isolation, and food intake.
这项研究的目的是探索在老年人中实施的技术解决方案,并与应用程序管理员监督的应用程序连接,如何减少孤独感,防止营养不良,并激发社交饮食和社交网络。2020年10月,一项调查被分发给了一键式计算机通信工具Komp的3500名管理员。Komp由一个放置老年人的屏幕和一个由该工具管理员使用的应用程序组成。该调查涉及的方面可以为老年人如何使用数字解决方案作为与家庭和外部网络的联系提供新的见解。研究结果显示,由于新冠肺炎,65%的受访者表示他们比以前更频繁地使用Komp,但目前只有5%的人与一起吃饭有关。然而,54%的应用程序管理员表示,这可能是一项很好的未来活动。此外,88%的人认为Komp可以通过共享用餐来促进更多的社交活动。这项研究引发了近1650条关于经验、使用和建议的建设性意见。研究结果表明,数字解决方案可以成为老年人及其家庭和外部网络之间的纽带。这些工具可以满足与孤独、社交孤立和食物摄入相关的需求。
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引用次数: 1
Association between Malnutrition Risk Factors and Physical Function in Community-Dwelling Adults ≥80 Years ≥80岁社区居民营养不良危险因素与身体功能的关系
Pub Date : 2023-01-06 DOI: 10.3390/jal3010003
S. F. Buhl, P. Ø. Olsen, T. Thilsing, P. Caserotti
Malnutrition is associated with accelerated loss of physical function in old adults, but the assessment of malnutrition in primary prevention is challenging. This study aimed to investigate if malnutrition risk factors; poor appetite, dysphagia, and poor dental state, were associated with reduced physical function in community-dwelling adults ≥80 years. The study is based on data from two cross-sectional studies. Physical function was assessed by the Short Physical Performance Battery (score ≤ 9 indicate reduced physical function) and poor appetite, dysphagia and poor dental status was assessed by single questions. A total of 900 participants were included (age 85.1 ± 3.7 years; 60.9% females; 62.8% had reduced physical function). Participants with reduced physical function were older, had a higher BMI, more polypharmacy, more falls, and lower quality of life. Poor appetite was reported by 10.8% and associated with reduced physical function (adjusted-OR 1.93, 95%CI 1.18–3.15). No association was identified between dysphagia, poor dental state and reduced physical function (adjusted-OR 0.96, 95%CI 0.53–1.75 and adjusted-OR 0.99, 95%CI 0.41–2.35, respectively). The assessment of appetite during primary preventive strategies was feasible and may offer an opportunity for identification of very old community-dwelling adults at risk of reduced physical function.
营养不良与老年人身体功能的加速丧失有关,但初级预防中营养不良的评估具有挑战性。本研究旨在探讨营养不良的危险因素;在≥80岁的社区居民中,食欲不振、吞咽困难和牙齿状况不佳与身体功能下降有关。这项研究基于两项横断面研究的数据。采用短体能测试(Short Physical Performance Battery)评估身体机能(得分≤9分表示身体机能下降),单题评估食欲不佳、吞咽困难和牙齿状况不佳。共纳入900名受试者(年龄85.1±3.7岁;60.9%的女性;62.8%身体机能下降)。身体功能下降的参与者年龄较大,身体质量指数较高,多种药物较多,摔倒较多,生活质量较低。10.8%的患者报告食欲不振,并伴有身体机能下降(调整比值比1.93,95%可信区间1.18-3.15)。吞咽困难、牙齿状况不佳和身体功能下降之间没有关联(调整后的or分别为0.96,95%CI 0.53-1.75和0.99,95%CI 0.41-2.35)。在初级预防策略期间对食欲进行评估是可行的,并可能为识别有身体功能下降风险的社区老年成年人提供机会。
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引用次数: 1
Arbiters of Time: The Experience of Adults Aging with Spinal Cord Injury. 时间的仲裁者:脊髓损伤的成年人衰老的经验
Pub Date : 2023-01-01 DOI: 10.3390/jal3010005
Lisa Reber, Nasya S W Tan, Michelle A Meade, Martin Forchheimer, Denise G Tate, Philippa Clarke

Time is a fundamental component of our lives. It is both objective, a structure outside of ourselves, and subjective, an element that is relative to the life we live and how we experience it. The disabled body must come to terms with time to understand the future impact of the injury and its progression, as well as how the injury will impose a new more accelerated aging process in the body, resulting in a compressed lifespan. The body also challenges time's control of the body. This paper extends the literature on the study of time to the experience of adults aging with a spinal cord injury (SCI). Drawing from interviews conducted with adults with long-term SCI, it examines how their narratives about aging and the proactive management of their lives reflect their orientation toward and anticipation of the future. Recognizing that the spoken word often carries a multiplicity of meanings, it considers what participants' words might imply about their engagement with time. The results of this study show that the process of aging is characterized by uncertainty and the expectations of functional and health decline, requiring a sense of urgency and vigilance in the face of the uncertain course of aging with SCI. Participants understood that their lifespan was compressed due to the physiological impact of accelerated aging. Knowledge of this compression made time a scarce resource. Yet, despite it being the arbiters of their futures, so too were they the arbiters of time.

时间是我们生活的基本组成部分。它既是客观的,是我们自己之外的一种结构,也是主观的,是一种与我们生活和体验方式相关的因素。残疾的身体必须接受时间,以了解损伤的未来影响及其进展,以及损伤将如何在身体中施加一个新的、加速的衰老过程,从而缩短寿命。身体也挑战时间对身体的控制。本文将时间研究的文献扩展到成年脊髓损伤(SCI)患者的经验。根据对长期SCI患者的采访,研究了他们对衰老的叙述和对生活的积极管理如何反映他们对未来的取向和预期。认识到口语通常具有多种含义,它考虑了参与者的话语对他们与时间的接触可能意味着什么。本研究结果表明,衰老过程具有不确定性以及对功能和健康下降的预期,需要在面对SCI衰老过程的不确定性时有紧迫感和警惕性。参与者明白,由于加速衰老的生理影响,他们的寿命被缩短了。对这种压缩的了解使时间成为稀缺资源。然而,尽管它是他们未来的仲裁者,但他们也是时间的仲裁器。
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引用次数: 0
Qualitative Study on Important Elements of Life for Japanese and Thai Older Adults 日本和泰国老年人重要生活要素的定性研究
Pub Date : 2022-12-30 DOI: 10.3390/jal3010002
Nobuko Shimizu, Takako Yamada, Nobuyuki Honda, Miyako Mochizuki, Mayumi Kato, Noboru Hasegawa, H. Sethabouppha, N. Suwankruhasn, Chalinee Suvanayos
Previous studies have demonstrated relationships between religiosity, physical and mental health-related outcomes, and healthy collective longevity. This qualitative study investigated the elements of pleasure and fulfillment in older adults living in the super-aged society of Japan and the rapidly super-aging society of Thailand. Semi-structured interviews were conducted with 14 older adults—seven from Japan, and seven from Thailand, covering five topics: (1) pleasures in daily life; (2) purpose in daily life; (3) thoughts about aging; (4) things they do actively for their health; and (5) things they worry about. Data were analyzed using the Steps for Coding and Theorization method. Japanese older adults mostly engaged in individually accomplished pleasures, whereas Thai older adults aimed to experience pleasures involving others. Thai older adults viewed aging as a natural phenomenon and stressed the importance of self-regulation. The Japanese participants, however, focused on activities that would avoid the burden of long-term care, maintain their current lifestyle, and help with self-improvement and lifetime learning. Although Thai older adults derived pleasure and fulfillment from being helpful toward others, Japanese older adults’ narratives indicated that they tended to worry about others. Differences between the two countries’ lifestyles, environments, beliefs, and religious contexts explain the differences in the mechanisms by which Japanese and Thai older adults experience joy, fulfillment, and purpose in life. These results suggest ways to improve quality of life, extend healthy life expectancy, and prevent cognitive decline in older adults thriving in aging societies.
先前的研究已经证明了宗教信仰、身心健康结果和健康的集体寿命之间的关系。这项定性研究调查了生活在日本老龄化社会和泰国快速老龄化社会的老年人的快乐和成就感要素。对14名老年人进行了半结构化访谈,其中7名来自日本,7名来自泰国,涵盖五个主题:(1)日常生活中的乐趣;(2) 日常生活目的;(3) 老龄化思想;(4) 他们为健康积极做的事情;以及(5)他们担心的事情。使用编码步骤和理论化方法对数据进行分析。日本的老年人大多从事个人完成的快乐,而泰国的老年人则致力于体验与他人有关的快乐。泰国老年人认为老龄化是一种自然现象,并强调自我调节的重要性。然而,日本参与者专注于避免长期护理负担、保持当前生活方式、帮助自我提升和终身学习的活动。尽管泰国老年人从帮助他人中获得快乐和满足感,但日本老年人的叙述表明,他们倾向于担心他人。两国生活方式、环境、信仰和宗教背景的差异解释了日本和泰国老年人体验快乐、成就感和人生目标的机制的差异。这些结果提出了提高生活质量、延长健康预期寿命和防止老龄化社会中老年人认知能力下降的方法。
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引用次数: 0
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Journal of ageing and longevity
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