Older adults have a lifetime of experience with change; however, many health care providers assume they are unable or unwilling to change their health behaviors. Practicing gerontology nurses, in collaboration with nurse researchers, have an opportunity to address this important issue. Both practitioners and researchers play a vital role in the development of evidence supporting effective health behavior change interventions for the aging population (Conn, Rantz, WipkeTevis, & Maas, 2001).
Change for older adults is not a simple phenomenon. They often face both positive and negative changes simultaneously. For example, they may have more freedom to select their activities because of decreased family and work responsibilities, but at the same time experience decreased mobility as a result of osteoarthritis. Similarly, the birth of a new grandchild is uplifting, while the loss of long-time friends is difficult. Coping with these changes is challenging, but older adults possess a lifetime of experience with change.
HEALTH BEHAVIOR CHANGE
Nurses often make suggestions related to health behavior changes for older adults with chronic conditions. For example, dietary changes are usually recommended for individuals with diabetes, as are activity changes for older adults with cardiac problems. Complex lifestyle changes may be necessary when older adults have numerous chronic conditions. Many older adults find these health behavior changes difficult to accomplish.
Considerable research has examined health behavior change. Changes in behavior, especially in those who have chronic illnesses, has generally been found to promote positive health outcomes among aging adults. For example, Topp, Mikesky, Dayhoff, and Holt (1996) reported older adults who participated in resistance exercise increased their strength and gait velocity, thereby improving their mobility.
Researchers have also tested interventions to help older adults change their exercise behaviors. For example, Conn, Valentine, and Cooper (in press) found interventions were most effective in increasing aging adults physical activity when they incorporated self-monitoring, targeted only exercise behavior, included group delivered interventions encouraging moderate activity, encouraged activity at fitness/exercise centers, and were delivered to disease specific patient groups.
Some interventions are designed to address the specific problems common to older adults, such as diabetes or arthritis. Lorig and Holman (1993) have tested an intervention to increase self-management skills among individuals with various rheumatic diseases and have shown that older adults who make positive changes in their health behavior experience significant decreases in joint pain. Recent research has tested arthritis related behavior change interventions designed for rural older adults (Burks, 2001). Further nursing research designed to answer important practice problems and provide evidence for effective interventions is urgently needed (Conn, Burks, Rantz, & Knudsen, 2002; Conn, Rantz, Wipke-Tevis, & Maas, 2001).
NURSES AAAKE A DIFFERENCE
Older adults face multiple changes as they grow older. Health behavior modifications are often required to cope with chronic illnesses and the normal changes brought about by aging. Practicing nurses and nurse researchers can work together in an effort to discover the most appropriate and effective interventions (Conn, Rantz, WipkeTevis, & Maas, (2001). Together we can make a difference in the lives of this generation as they age.
- Burks, K. (2001). Self-management of osteoarthritis: An intervention study. Unpublished doctoral dissertation, University of Missouri, Columbia.
- Conn, V., Burks, K., Rantz, M., & Knudsen, K. (2002). Evidence-based practice for gerontological nursing. Journal of Gerontological Nursing, 28(2), 45-52.
- Conn, V., Rantz, M., Wipke-Tevis, D-, & Maas, M. (2001). Designing effective nursing interventions. Research in Nursing & Health, 24(5), 433-442.
- Conn, V, Valentine, J., & Cooper, H. (in press). Interventions to increase physical activity among aging adults: A metaanalysis. Annals of Behavioral Medicine.
- Lorig, K., & Holman, H. (1993). Arthritis selfmanagement studies: A twelve year review. Health Education Quarterly, 20(1), 17-28.
- Topp, R., Mikesky, ?., Dayhoff, N. E., & Holt, W. (1996). Effect of resistance training on strength, postural control, and gait velocity among older adults. Clinical Nursing Research, 5(4), 407-427.