A Concept Analysis of Healthy Aging

Background: This article describes the application of the vulnerable populations conceptual model to rural health. Vulnerable populations are social groups who have an increased susceptibility to adverse health outcomes. Evidence of this differential in vulnerability or increased risk includes premature mortality, comparative morbidity, decreased functional status, and diminished quality of life.

Organizing Framework:  The vulnerable populations conceptual model postulates that there are interrelationships among resource availability, relative risk, and health status. Resource availability speaks to socioeconomic and environmental resources that are operationalized in this model as income, jobs, education, housing, availability of health care, quality of health care, and patterns of family and community life. Relative risk addresses the likelihood of exposure to risk factors and is reflected in lifestyle behaviors and choices and exposure to stressful events. Health status is operationalized as morbidity and mortality.

Findings:  This review of the literature supports the utility of the vulnerable populations conceptual model in working with rural populations.

Implications:  This model has potential utility to inform nursing research, practice, and policy about the opportunities and resources needed to achieve and maintain health in rural communities.

The application of a vulnerable populations conceptual model to rural health

The purpose of this descriptive correlational study was to examine the relationships among health-promoting behaviors, perceived social support, and self-reported health of 113 persons age 55 years and over, who were attending nutrition sites in northern West Virginia. Three hypotheses were formulated: (1) health-promoting behaviors are positively related to perceived social support; (2) health-promoting behaviors are positively related to self-reported health, and (3) perceived social support is positively related to self-reported health. Only the first two were supported by our findings. Data analysis revealed positive correlations between the average health-promoting lifestyle profile (HPLP) score and education, and frequency of attending the nutrition site screening clinics for high blood pressure and diabetes. Better-educated subjects scored higher on selected subscales of the HPLP (self-actualization and health responsibility). Age was negatively correlated with the HPLP subscales of health responsibility and exercise. Nurses and support personnel at nutrition sites should focus increased attention on the older participants and those who are less well-educated. Expanding the variety and frequency of health services available to nutrition site participants merits attention.

Health-promoting behaviors, perceived social support, and self-reported health of Appalachian elderly

Rural health and health-seeking behaviors.

This article describes two courses, Health in Rural Appalachia and Clinical Practice in Appalachia, developed by one of the authors to increase students’ cultural competence as professional nurses....

Teaching culturally competent care: nursing students experience rural Appalachia.

In this research project we explored beliefs about healthy aging in an Appalachian community. A major goal was to develop theory for community health nursing interventions that promote and maintain health during the aging process. A convenience sample of 105 community informants responded to an open-ended interview schedule that elicited beliefs and values of health and aging. The data were analyzed for the purpose of producing grounded theory; a major category that emerged portrayed the aging process as a collection of attitudes about oneself. Health was described as feeling good and being able to enjoy life. The informants reported that health is maintained by good nutrition, exercise, and an environment that is safe and promotes individual growth and development. A beginning theory of independence through self-care and client involvement emerged from the data analysis. A second component of the theory suggested that to promote healthy aging, nursing interventions should be directed toward aggregate populations. Nursing interventions that are grounded in the understanding of cultural beliefs and practices are likely to be more beneficial to clients than those that ignore or displace such beliefs and practices. This theory has the potential of being extended to a variety of settings.

Toward healthy aging: a theory for community health nursing.

This article describes a method of linking curriculum and the nursing role in health policy. Graduate students participated in a project to assess the impact of policy on the health of a community and the implications for nursing. The experience of this project indicates that learning about policy within a community context has merit for helping students understand the impact of policy on nursing.

Nursing, health, and policy within a community context.

GENESIS (General Ethnographic and Nursing Evaluation Studies In the State) is a tested and proven community analysis strategy that integrates ethnographic and epidemiologic data to arrive at a comprehensive, holistic description of the health of a community and its residents. Communities analyzed in most project GENESIS studies have been rural or semirural. ACTION (Assessing Communities Together in the Identification Of Needs) is an extension of the GENESIS community analysis model that was developed to meet the unique needs of community-level research and analysis in an urban, multicultural setting. Significant differences in the context in which the ACTION projects took place necessitated extensions in specific components of the GENESIS model. Application of the GENESIS model by the ACTION team is described. Based on the experiences with ACTION, recommendations are offered for future urban, multicultural community analysis projects.

Mona M. Counts

Papers

Toward healthy aging: a theory for community health nursing.

Nursing, health, and policy within a community context.

ACTION: application and extension of the GENESIS community analysis model.