The Influence Of Social Participation On Subjective Well-being Of The Elderly With Low Vision In The Context Of Healthy Aging

ObjectiveTaking the elderly with low vision in the main urban area of Chongqing as an example,this study investigated and analyzed the current situation of subjective well-being and social participation status of the elderly with low vision;to analyze the impact of participation in social activities and feelings of social participation on the subjective well-being of the elderly with low vision and the action path respectively;to explore the types of social participation of the elderly with low vision,and analyze the factors that influencing their choice of participation types,digging deeply into the cognition and demands of the elderly with low vision for social participation.the purpose of this study is to provide accurate and reliable reference for formulating nursing intervention strategies for low vision,improving the subjective well-being of the elderly with low vision,and promoting the development of health care services for the elderly with low vision.Methods1.A survey of Subjective well-being and social participation in the elderly with low visionThe questionnaire containing general socio-demographic data and basic health status,memorial University of Newfoundland scale of happiness and community participation index,were used to select the elderly with low vision who were followed up in the ophthalmology outpatient department of two Grade A tertiary hospital in Chongqing as the survey objects by objective and convenient sampling method,thus investigating and analying the status and characteristics of social activity participation,subjective feelings and subjective well-being of the elderly with low vision at present.2.To analyze the influence of social participation on subjective well-being of the elderly with low visionPearson correlation analysis was used to analyze the correlation between social support,vision-related quality of life,social participation and subjective well-being.Based on the review of previous relevant research literature and theoretical model,according to the correlation analysis results,A prediction model of the mediating effects of social participation(social participation activities and subjective feelings of social participation)mediated by social support and vision-related quality of life on subjective well-being was established.Linear regression analysis was used to test the social support,vision-related quality of life mediating social participation activities 、 subjective feelings of social participation and subjective well-being respectively,and Bootstrap method was used to test the mediating effect.3.To explore the types of social participation of the elderly with low vision and their cognition and demands for participationThe method of convenience and purpose sampling was adopted to select the research objects,and the principle of saturated interview information is adopted to analyze the interview data by the content analysis method of descriptive research.Based on the classification framework of social activities of Levasseur’s,deductive content analysis was used to establish a structural classification matrix,and specific forms of social participation described by the elderly with low vision wew coded and classified according to the structure of the classification matrix.After deductive analysis,inductive content analysis was used to further analyze the interview data.According to the research purpose,the factors influencing their choice of social participation type and their cognition and demands for social participation were explored.Results1.Social participation and subjective well-being of the elderly with low visionIn this study,the social participation of the elderly with low vision included the frequency of participation in social activities and the subjective perception of social participation.The survey results showed that the frequency of social participation was mainly concentrated in family activities(11.35±3.91 points),while the frequency of participation in work roles(3.20±2.21 points)and social recreational activities(2.75±2.94 points)was low.The importance of social participation activities showed that Participation in family activities is more important than participation in work roles and social recreational activities.The results showed that the demand for participation in social recreational activities ranked first,followed by the demand for participation in family activities and work roles.The results of subjective perception of social participation showed that the obstacle to perception of participation was greater(111.16±17.93 points),and the obstacle of importance of perception participation(62.74±8.69 points)was greater than the obstacle of controllable perception participation(48.42±10.30 points).The results showed that the overall subjective well-being of the elderly with low vision score was 24.75±8.02,with 83.21% at medium level(25.31±6.25 points),and 6.93% at high level(37.79±8.02 points).The low level(10.85±1.38points)accounted for 9.85%,and the mean values of positive emotional experience score were 4.70±2.50 、 6.20±2.90 respectively,and the mean values of negative emotional experience score were 3.52±1.74、6.64±2.13 respectively.2.The impact of social participation on subjective well-being of the elderly with low vision(1)Demographic differences of subjective well-being in the elderly with low vision:Independent sample T-test and one-way analysis of variance showed that there were significant differences in the subjective well-being of the elderly with low vision among the education level(p<0.05),marital status(p<0.01),monthly income per capita(p<0.001)and whether have any other chronic diseases(p<0.001).(2)Correlation analysis: there was a significantly positive correlation among social participation activities and social support(r=0.740,p<0.01),vision-related quality of life(r=0.604,p<0.01)and subjective well-being(r=0.695,p<0.01);a significantly positive correlation with subjective feelings of social participation and social support(r=-0.885,p<0.01),vision-related quality of life(r=-0.674,P<0.01)and subjective well-being(r=-0.809,p<0.01).(3)The influence of social participation on subjective well-being: Social participation positively predicted subjective well-being,and the direct effect was 0.123.Social support and vision-related quality of life played partial mediating roles in the influence of social participation on subjective well-being,and the mediating effect were 0.434 and 0.215 respectively.The subjective experience of social participation negatively predicted subjective well-being,and the direct effect was-0.111.The effect of social participation perception on subjective well-being was influenced by social support and vision--related quality of life,and the mediating effect was-0.152 and-0.086 respectively.3.Types of social participation of the elderly with low vision and their cognition and demands for participationBy repeated coding,classification,comparative extraction and reclassification of the interview data,guided by the Levasseur’s classification of social activities,the results of deductive analysis showed that,the types of social participation of the elderly with low vision mainly focus on the third and fourth layers of Levasseur’s social activity classification,which were goal-oriented social participation.The results of induction and analysis formed three themes,including single factors affecting the type of social participation(limited ability to act,insufficient family social support,excessive psychological burden),strong intention of social participation(desire to interact with others,desire for social support),and identification of social participation(positive emotional experience,improvement of mental state).Conclusion1.The overall scores of social participation and subjective feelings of social participation in the elderly with low vision are lower;Subjective well-being is below the medium level,and the positive emotion is slightly higher than negative emotion,suggesting that the nursing staff should not only provide specialized care related to eye diseases for the elderly with low vision,but also consider promoting the overall health of the elderly with low vision from the perspective of social function and happiness.2.Social participation activities and subjective feelings of social participation can not only directly affect the subjective well-being of the elderly with low vision,but also indirectly affect their subjective well-being through the social support and vision-related quality of life,which can provide relevant reference suggestions for the construction of intervention measures to promote the subjective well-being of the elderly with low vision.3.The elderly with low vision have a single type of social participation,although affected by action ability,family social support and psychological factors,they still have positive cognition of social participation and strong willingness to participate in society,which will help to further enrich nursing strategies for improving the overall health of the elderly with low vision from the perspective of social participation.In conclusion,the level of subjective well-being and social participation of the elderly with low vision are not optimistic.In addition to the demographic factors,promoting social participation,increasing social support,maintaining and improving the quality of life related to visual function will help to improve the subjective well-being of the elderly with low vision.