overview of Flood's theory of successful aging
“an individual's perceived favorable outcome in adapting to the cumulative physiologic and functional changes associated with the passage of time, while experiencing spiritual connectedness and a sense of meaning or purpose in life” (Flood, 2005, p.36).
fRamework of the theory : Coping Processes
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- Gerotranscendence is key to successful aging
- To achieve gerotranscendence, individuals must master three foundational coping processes around the areas of the body, mind and soul:
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- 1). Functional Performance Mechanisms
- 2). Intrapsychic Factors
- 3). Spirituality
- (Flood, 2005)
evaluation of the theory
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Consistency
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Flood’s model achieves internal consistency in that she outlines three coping processes, adaptation of functional performance mechanisms, intrapsychic factors and spirituality, and goes on to articulate constructs within each that are measurable and observable output responses (Flood, 2005). Additionally, despite the fact that Flood’s model details activities and characteristics that occur simultaneously, without a clear beginning point and relate to all others in a cyclical fashion, she provided clear, concise definitions for each dimension of the theory (Flood, 2005). Finally, flood theory provides a framework for nursing interventions that address the mental, physical, and spiritual health of the aging person (Flood, 2005).
Parsimony
Flood’s Theory of Successful Aging (2005) is not parsimonious due to its multilayered nature of the foundations of coping processes which interconnect to gerotranscendence and ultimately lead to successful aging. Each of the coping processes are termed “dimensions”, and within each dimension there are constructs that are measurable and observable as output. In her article “A Mid-Range Nursing Theory of Successful Aging” (2005), Flood worked to describe the background theories that fed into the development of the Successful Aging Theory, such as Roy’s Adaptation Model (1997) and Tornstam’s sociological theory of gerotranscendence (1997); but she is not quite elegant at being clear and concise with her descriptions and organization of discussion of the theory. So while in trying to understand where the theory comes from, one can get very overwhelmed by the Matrushka-like nesting of theories that play into unpacking the development of Successful Aging Theory. In and of itself, successful aging is not likely to be unclear to nurses, but developing an understanding of the theory and its working parts needs to be done in a more succinct manner.
adequacy
feasibility
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It is feasible to implement practices derived from this theory. A holistic outlook and perhaps a paradigm shift in medical care towards holism and preventative care will reduce the need of medical intervention while increasing nursing care that is focused around the mental health and personal development of aging persons. Practice has been implemented with concrete actions from this theory as shown by a recent study done investigating “Successful Aging Among Assisted Living Community Older Adults” by Kozar-Westman, Troutman-Jordan, & Nies (2013). This study was successful in proving successful aging is possible in a particular sample of a large and growing population sector. By adopting “meaningful practices and interventions” (Kozar-Westman, Troutman-Jordan, & Nies, 2013, p. 238) for this population, they were able to refine a few of the specific interventions that led toward gerotranscendence.
testability
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There are four domains of Flood’s middle range theory including functional performance, intrapsychic factors, spirituality, and gerotranscendence. Indicators of functional performance mechanisms are health promotion activities, physical health, and physical mobility. Creativity, low levels of negativity, and personal control are the indicators of intrapsychic factors. Output responses of spirituality comprise religiosity and spiritual perspective. Indicators of gerotranscendence include decreased death anxiety, engagement in meaningful activities, self-acceptance, changes in relationships, and wisdom (Flood, 2005).
Instruments such as the Proactive Coping Subscale of the Proactive Coping Inventory and Reed's Self transcendence Scale (STS) can be used to measure adaptation and transcendence respectively (McCarthy, 2011). Hierarchical multiple regression was used to analyze the effects of predictors on successful aging (McCarthy, 2011). Measuring opinion or experience on Likert scales enable trends to be seen as well. However, not everything in Mid-Range theory can be quantified, because much of the coping processes are about feelings, thoughts and awareness. These qualitative measures make data analysis difficult and potentially meaningless.
Instruments such as the Proactive Coping Subscale of the Proactive Coping Inventory and Reed's Self transcendence Scale (STS) can be used to measure adaptation and transcendence respectively (McCarthy, 2011). Hierarchical multiple regression was used to analyze the effects of predictors on successful aging (McCarthy, 2011). Measuring opinion or experience on Likert scales enable trends to be seen as well. However, not everything in Mid-Range theory can be quantified, because much of the coping processes are about feelings, thoughts and awareness. These qualitative measures make data analysis difficult and potentially meaningless.