Table Of ContentD 954 ACTA Danica Železnik
D954etukansi.kesken.fm Page 1 Wednesday, October 24, 2007 3:08 PM
OULU 2007
D 954
UNIVERS ITY OF OULU P .O . Box 7500 F I -90014 UNIVERS ITY OF OULU F INLAND
U N I V E R S I TAT I S O U L U E N S I S
A C T A U N I V E R S I T A T I S O U L U E N S I S
ACTA
D
S E R I E S E D I T O R S MEDICA
Danica Železnik
ASCIENTIAE RERUM NATURALIUM
Profesor Mikko Siponen SELF-CARE OF THE HOME-
BHUMANIORA DWELLING ELDERLY PEOPLE
Professor Harri Mantila
LIVING IN SLOVENIA
CTECHNICA
Professor Juha Kostamovaara
DMEDICA
Professor Olli Vuolteenaho
ESCIENTIAE RERUM SOCIALIUM
Senior Assistant Timo Latomaa
FSCRIPTA ACADEMICA
Communications Officer Elna Stjerna
GOECONOMICA
Senior Lecturer Seppo Eriksson
EDITOR IN CHIEF
Professor Olli Vuolteenaho
EDITORIAL SECRETARY
Publications Editor Kirsti Nurkkala FACULTY OF MEDICINE,
DEPARTMENT OF NURSING SCIENCE AND HEALTH ADMINISTRATION,
UNIVERSITY OF OULU;
ISBN 978-951-42-8636-0 (Paperback) FACULTY OF HEALTH SCIENCES,
ISBN 978-951-42-8637-7 (PDF) UNIVERSITY OF MARIBOR
ISSN 0355-3221 (Print)
ISSN 1796-2234 (Online)
A C T A U N I V E R S I T A T I S O U L U E N S I S
D M e d i c a 9 5 4
DANICA ŽELEZNIK
SELF-CARE OF THE HOME-
DWELLING ELDERLY PEOPLE
LIVING IN SLOVENIA
Academic dissertation to be presented, with the assent of
the Faculty of Medicine of the University of Oulu, for
public defence in Kajaaninsali (Auditorium L6), Linnanmaa,
on November 30th, 2007, at 12 noon
OULUN YLIOPISTO, OULU 2007
Copyright © 2007
Acta Univ. Oul. D 954, 2007
Supervised by
Professor Helvi Kyngäs
Doctor Kaisa Backman
Professor Dušanka Mičetić-Turk
Reviewed by
Professor Emerita Maija Hentinen
Docent Riitta Suhonen
ISBN 978-951-42-8636-0 (Paperback)
ISBN 978-951-42-8637-7 (PDF)
http://herkules.oulu.fi/isbn9789514286377/
ISSN 0355-3221 (Printed)
ISSN 1796-2234 (Online)
http://herkules.oulu.fi/issn03553221/
Cover design
Raimo Ahonen
OULU UNIVERSITY PRESS
OULU 2007
Železnik, Danica, Self-care of the home-dwelling elderly people living in Slovenia
Faculty of Medicine, Department of Nursing Science and Health Administration, University of
Oulu, P.O.Box 5000, FI-90014 University of Oulu, Finland; Faculty of Health Sciences, University
of Maribor, Žitna ulica 15, SI-2000 Maribor, Slovenia
Acta Univ. Oul. D 954, 2007
Oulu, Finland
Abstract
This study is focused on the self-care of home-dwelling elderly people living in Slovenia. The study
has two phases. The purpose of the first phase is to describe the self-care of home-dwelling elderly
people living in Slovenia and factors connected to self-care. The purpose of the second phase is to
describe the experiences of the elderly people's ability to manage at home. The aim of this study was
to produce new knowledge about the self-care of home-dwelling elderly people living in Slovenia and
the factors connected with it. The knowledge will be used to develop elderly care and support eldery
people who live at home. The knowledge can be also used to educate nurses to care for the elderly
people.
The study was both quantitative and qualitative. In the quantitative study the sample consisted of
302 home-dwelling elderly people who were clients in domiciliary care. The selection criteria was:
aged 75 years or over and the ability to communicate, no hearing problems, no severe mental
problem/cognitive disability and gave full consent for their participation.
The whole instrument consists of 91 items. A instrument covers background data, types of self-
care, self-care orientation, life satisfaction, self-esteem and functional ability. In the qualitative study,
20 interviews were carried out and a qualitative analysis obtained. Data collection methods included
open-ended questions concerning the following topics: background data, types of self-care, self-care
orientation, life satisfaction, self-esteem and functional ability.
Based on factor analyses, four factors were found which described the self-care. All other factors
describe elderly people's perceptions concerning either the past or the future. The elderly people who
are able to manage their daily activities/routines have a good functional capacity, good family
relations, live qualitatively, accept the future healthily and clearly and are satisfied with their life
because they can take care of themselves, but their self-esteem is not so high. Those elderly people
who do not take care of themselves are abandoned; they are not satisfied with their way of life and
have low-esteem.
The results are going to be the basis for planning care and nursing care for all caregivers,
especially community nurses. On the basis of this result the model of nursing and social care for home
-dwelling elderly people living in Slovenia could be planned.
Keywords: aged, functional ability, home-dwelling elderly people, life satisfication, self-
care, self-esteem, self-orientation
Acknowledgement
This study was carried out at the University of Oulu, Department of Nursing in
Finland. I would like to express my sincere thanks to all those who have been of
special importance to me at all stages of this work.
I would like to take this opportunity to extend my warmest thanks to my
dean, prof. dr. h. c., dr. Dušanki Mičetić – Turk for idea that I start my PhD at
University of Oulu and for all her help and support. I wish to thank prof. Dr. Arja
Isola for all her warmest help and support and dr. Kaisa Backman for all help and
kindly attitude at the beginning of my study. My especial thanks go to my
supervisor, prof. Dr. Helvi Kyngäs, who has given me invaluable help and
support. I wish my warmest thanks also to both referees prof. dr. Maija Hentinen
and prof. dr. Riitta Suhonen for their comments what helped me finished this
work. I am grateful to docent Päivi Voutilainen who is commited to opponent me.
Especially I am very grateful to Mrs. Alenka Marsel for all her invaluable
help and encouragement, without her I could not finish this work.
I would like to give my special thanks to Mr. Alojz Tapajner and to librarian
Mrs. Nevenka Balun and Mrs. Simona Novak.
Warm thanks go to my dearest friend and colleague Mrs. Antonija Ivanuša for
her warm support, empathy, personal growth and friendship.
I have to thank also to my English teacher Mr. Miran Jarc. Thanks goes also
to all community nurses expecialy to Mrs. Tatjana Geč.
Finally, I would like to thank my family for understanding and support from
the bottom of my hart, to husband Milan, daughter Polonca and son Uroš. Without
them I could not make it.
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Contents
Abstract
Acknowledgement 5
Contents 7
1 Introduction 9
1.1 Background of the present study............................................................... 9
1.2 Context of the study .................................................................................11
1.2.1 Principles and general rights of elderly people in the field
of health care in Slovenia ............................................................. 12
1.3 Purpose of the study................................................................................ 15
2 Self-care of the elderly people 17
2.1 Definitions of self-care............................................................................ 17
2.2 Self-care and factors connected to it ....................................................... 19
2.2.1 Functional capacity....................................................................... 20
2.2.2 Life satisfaction ............................................................................ 21
2.2.3 Self-esteem ................................................................................... 22
2.2.4 Self-care and disability ................................................................. 23
2.2.5 Self - care of the elderly related to mental health......................... 24
2.3 Self-care of elderly people, quality of life and well-being...................... 25
3 Background theory of the study 29
4 Aim of the study and research problems 31
5 Methodology 33
5.1 Sampling ................................................................................................. 34
5.1.1 Phase I .......................................................................................... 34
5.1.2 Phase II ......................................................................................... 37
5.2 Data collection ........................................................................................ 38
5.2.1 Phase I .......................................................................................... 38
5.2.2 Phase II ......................................................................................... 40
5.3 Data analyses .......................................................................................... 41
5.3.1 Phase I .......................................................................................... 41
5.3.2 Phase II ......................................................................................... 42
5.4 Ethical considerations ............................................................................. 43
6 Results 45
6.1 The self-care of home-dwelling elderly people....................................... 45
6.2 The self-care orientation ......................................................................... 55
6.3 The self-esteem of home-dwelling elderly people .................................. 57
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6.4 The life satisfaction of home-dwelling elderly people ............................ 58
6.5 The functional capacity of home-dwelling elderly people ...................... 58
6.6 Functional capacity, life satisfaction and self-esteem related to
the self-care behavioural styles of home-dwelling elderly people .......... 59
6.7 The experiences of the elderly people concerning their ability to
manage at home....................................................................................... 63
6.8 Main findings of the results..................................................................... 65
7 Discussion 67
7.1 Reliability and validity of the study ........................................................ 67
7.1.1 Validity and reliability of the instrument ...................................... 67
7.2 Validity of qualitative study .................................................................... 71
7.3 Discussion about findings ....................................................................... 72
7.3.1 Functional capacity and self-care ................................................. 75
7.3.2 Life satisfaction of self-care ......................................................... 76
7.3.3 Self-esteem and self-care.............................................................. 77
7.3.4 Self-care connection to functional capacity, life
satisfaction and self-esteem.......................................................... 77
7.4 Discussion about the possibilities for care for home-dwelling
elderly people .......................................................................................... 78
7.5 Challenges for nursing practice and further research .............................. 79
8 Conclusion 81
References 83
Appendices 101
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