Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults

Spiritual care for older people living in the community: A scoping review

BACKGROUND

The population of older people should be supported to enjoy optimal quality of life. Health professionals should consider a range of interventions that support the older population to maintain their quality of life. One such interventional approach involves spiritual care.

OBJECTIVE

To explore what is known about spiritual care approaches for older people living in the community.

METHODS

Scoping review informed by Joanna Briggs Institute guidelines. Eight electronic databases were searched: CINAHL, Ageline, PubMed, ProQuest Nursing & Allied Health, PsycINFO, Scopus, Garuda, and Neliti. The review included quantitative and qualitative primary peer-reviewed research studies focusing on spiritual care interventions for older people living in the community published between 2011 and 2021 in English or Bahasa Indonesia. The search was uploaded into an electronic citation manager and imported into Covidence for screening.

RESULTS

A total of 29 studies were included in the review. While the studies were conducted in five continents, most were reported from the Asian continent. Five key issues based on the outcome of interventions were found namely psychological, physical, spiritual, multidisciplinary approach, and social connection.

CONCLUSION

This scoping review identifies spiritual interventions conducted across many countries have been implemented for older people living in the community. Although there are review limitations and further research is needed, these spiritual interventions, both faith-based and non-faith-based, are identified as useful to support the well-being of older people.

Qualitative Research on Self-Transcendence in Older Adults: A Scoping Review

The current scoping review describes qualitative research on self-transcendence (ST) in older adults. Articles from five databases were independently screened and data were extracted from predetermined categories. Results were compared and consensus reached through discussion. The two leading theorists guiding the chosen studies were Pamela Reed and Lars Tornstam. Experiential language in the studies most often touched on intrapersonal and interpersonal ST. Two main gaps identified in the literature were: (a) limited coverage of transpersonal aspects of ST, and (b) limited inclusion of experiential language of study participants. More qualitative research, phenomenology in particular, can shed light on the topic of ST. A deeper understanding of all aspects of ST, including experiential language used to describe it, can lay a foundation for nursing to advance with theory formation, scale construction, and interventions to better promote spiritual and psychological well-being in older adults. [Journal of Gerontological Nursing, 49(9), 43-48.].

Self-transcendence among adults 65 years and older: A meta-analysis

INTRODUCTION

Self-transcendence is a human capacity for wellbeing by expanding one's personal boundaries and may act as a health-promoting resource among adults ≥65 years. Therefore, the objectives of this meta-analysis were to determine the mean score of self-transcendence based on place of residence and gender, and to evaluate the correlations of self-transcendence with meaning, sense of coherence, resilience and depression.

METHODS

Based on inclusion criteria, 13 studies were included. Orwin Safe N and Egger's test assessed publication bias. The mean score of self-transcendence and the correlation coefficients of the selected variables were estimated by random effects models.

RESULTS

The self-transcendence mean score (n = 1634) was low (M = 43.6) and a bit lower among those staying in care facilities (M = 42.8), but did not vary significantly across gender. The correlation coefficients were self-transcendence_depression (r = -0.40), self-transcendence_meaning-in-life (r = 0.53), self-transcendence_resilience (r = 0.50) and self-transcendence_sense of coherence (r = 0.28). The correlation coefficients, except for meaning-in-life, were homogeneous.

CONCLUSION

In a health-promoting perspective, the concept of self-transcendence can help to better understand wellbeing among older individuals and provide guidance for health professionals in facilitating wellbeing and health. The concept and theory of self-transcendence can inspire health professionals in realising new health-promoting approaches to support older individuals in maintaining health, wellbeing and independency.

The sampling precision of research in five major areas of psychology

After obtaining a sample of published, peer-reviewed articles from journals with high and low impact factors in social, cognitive, neuro-, developmental, and clinical psychology, we used a priori equations recently derived by Trafimow (Educational and Psychological Measurement, 77, 831-854, 2017; Trafimow & MacDonald in Educational and Psychological Measurement, 77, 204-219, 2017) to compute the articles' median levels of precision. Our findings indicate that developmental research performs best with respect to precision, whereas cognitive research performs the worst; however, none of the psychology subfields excelled. In addition, we found important differences in precision between journals in the upper versus lower echelons with respect to impact factors in cognitive, neuro-, and clinical psychology, whereas the difference was dramatically attenuated for social and developmental psychology. Implications are discussed.

Mindful Eating: Connecting With the Wise Self, the Spiritual Self

In the Mindfulness-Based Eating Awareness Training program (MB-EAT) (Kristeller and Wolever, 2014; Kristeller and Wolever, in press), mindfulness practice is taught, mindful eating is cultivated, and self-acceptance and spiritual well-being are enhanced. An integrative concept is the value of cultivating ‘wisdom’ in regard to creating a new and sustainable relationship to eating and food. ‘Wisdom’ refers to drawing on personal experience and understanding in a flexible, insightful manner, rather than strictly following external rules and guidelines. Several clinical trials involving variations of MB-EAT have documented substantive improvement in how people relate to their eating, including individuals with both binge eating disorder (BED) and subclinical eating issues. Based on the traditional value of contemplative practices for cultivating spiritual engagement, and on evidence from related research showing that spiritual well-being increases in the Mindfulness-Based Stress Reduction (MBSR) program and is related to other effects, we hypothesized that the MB-EAT program would also engage this aspect of experience, as assessed by the Functional Assessment of Chronic Illness Therapy – Spiritual Well-Being subscale (FACIT-Sp), and that increases in spiritual well-being would relate to other measures of adjustment such as emotional balance and improvement in disordered eating. Participants (N = 117) with moderate to morbid obesity, including 25.6% with BED, were randomly assigned to MB-EAT or a wait-list control, and assessed on the FACIT-Sp and other measures at baseline, immediate post (IP), and 2-month followup (F/Up). Both FACIT-Sp factors [Meaning/Peace (M/P) and Faith] increased significantly in the MB-EAT group and were stable/decreased in the control group. Increases in these factors related to improvement in emotional adjustment and eating regulation at IP and at F/Up, and to increases in aspects of mindfulness measured by the Five Facet Mindfulness Questionnaire (FFMQ). Increases in M/P during treatment mediated effects of the FFMQ Observe factor on eating regulation and depression at IP. Results are discussed in terms of the role that mindfulness practice plays in cultivating ‘wise mind’ and the related value of spirituality. It is argued that the core elements of the MB-EAT program lead to meaningful spiritual engagement, which plays a role in people’s ability to improve and maintain overall self-regulation.

Facilitating Self-Transcendence: An Intervention to Enhance Well-Being in Late Life

This randomized controlled pilot study evaluated the effects of the Psychoeducational Approach to Transcendence and Health (PATH) Program, an 8-week intervention hypothesized to increase self-transcendence and improve well-being in community-dwelling women aged 60 years and older ( N = 20). The PATH combined mindfulness exercises, group processes, creative activities, and at-home practice using community engaged research methods. Findings provided some support for the effectiveness of PATH. Although there was no significant Group × Time interaction, self-transcendence, psychological well-being, and life satisfaction differed significantly pre- and postintervention in the wait-listed control group, which received a revised version of the program. Further study is needed with a larger sample to determine the effectiveness of PATH. Potentially, PATH may be a convenient and affordable activity to support personal development and improve well-being among older adults at senior centers, retirement communities, nursing homes, church groups, and other places where older adults gather.