Meaning Reflectivity in Later Life: The Relationship Between Reflecting on Meaning in Life, Presence and Search for Meaning, and Depressive Symptoms in Older Adults Over the Age of 75

The Role of Meaning in the Retirement Transition: Scoping Review

BACKGROUND AND OBJECTIVES

The retirement transition is a period of major change and instability, which may challenge a person's sense of meaning in life. This scoping review sought to characterize the current research on the role of meaning in the retirement transition.

RESEARCH DESIGN AND METHODS

This scoping review was conducted according to Joanna Briggs Institute (JBI) and PRISMA reporting guidelines. Database searches of Scopus, PubMed, PsycINFO, Social Science Database, and ProQuest Dissertations and Theses Global yielded 738 records (after duplicates removed). Accessory searches yielded an additional 286 records. Eligible articles included peer-reviewed literature and theses (qualitative and quantitative) that explored an aspect of meaning in the context of the retirement transition.

RESULTS

A total of 30 studies (21 qualitative and 9 quantitative) were included. These studies examined a broad range of research questions on different aspects of meaning-meaning in life, meaning-making, meaningful engagement, and meaning of retirement. Most were single, stand-alone studies (not part of a broader research program) that included only a single time point. Only 6 studies were longitudinal.

DISCUSSION AND IMPLICATIONS

This review revealed a heterogeneous set of studies and identified gaps in reporting of important participant characteristics, lack of conceptual clarity in defining meaning, and few longitudinal studies. There is a need for more theoretically driven, programs of research that include longitudinal designs, ideally using mixed-methods approaches, to build a richer understanding of the role of meaning during this major life transition.

Recurrent pain in older age: A cross-sectional network analysis of biopsychosocial-existential interactions

OBJECTIVE

Chronic pain is a prevalent condition in older adults, associated with substantial distress. For many older people, chronic pain interferes with their daily life which is reflected in various life domains. This study aimed to investigate whether interactions among self-reported indicators of biological, psychological, social, and existential life domains differ for older adults with no pain, with non-interfering pain, and with interfering pain.

METHOD

The study was based on the cross-sectional 65+ and Safe Study data (N = 622; age range 64-106 years; 60.6 % women). Network analysis was used to assess the inter-variable associations for older adults reporting no pain, non-interfering pain, and interfering pain separately. Network visualization and centrality tests were performed. Permutation-based analyses were conducted to investigate the connections among variables in three subgroups.

RESULTS

We identified a structural difference between the networks of older adults with no pain and interfering pain, suggesting differences in connectivity among the life domains. The strength centrality metrics showed the central role of presence of meaning in the networks of older adults with no pain and with non-interfering pain, while for older adults with interfering pain, anxiety appeared to be dominant.

CONCLUSION

The findings illuminated that anxiety regulation and meaning-enhancement are potentially important intervention targets for older adults with recurrent pain. Overall, the study highlighted the value of a holistic biopsychosocial-existential approach for understanding and managing pain in older adults.

The Mediating Effect of Caregiving Relationship Quality on the Association Between Caregiving Stressors and Mental Health Problems Among Older Spousal Caregivers

Providing care to a spouse can be especially challenging for older adults given their compounding stressors resulting from aging and caregiving. This cross-sectional study examines the relationships between caregiving stressors and caregiver mental health problems and the potential mediator (i.e., caregiving relationship quality) of these associations. A total of 431 Americans (≥65 years) were selected from the National Study of Caregiving. Path analysis shows that care assistance was positively associated with caregiver mental health problems, and this association was mediated by negative relationship quality (Indirect effect  =  .14, p  =  .016). Moreover, role overload was positively associated with caregiver mental health problems, which was mediated by negative relationship quality (indirect effect  =  .13, p  =  .002). Findings suggest that caregiving stressors can adversely affect mental health by exacerbating negative relationship quality. Interventions that limit negative exchanges and increase compassionate communications between older spousal caregivers and their care-receiving partners are needed.

The aging mind: A complex challenge for research and practice

Cognitive decline as part of mental ageing is typically assessed with standardized tests; below-average performance in such tests is used as an indicator for pathological cognitive aging. In addition, morphological and functional changes in the brain are used as parameters for age-related pathological decline in cognitive abilities. However, there is no simple link between the trajectories of changes in cognition and morphological or functional changes in the brain. Furthermore, below-average test performance does not necessarily mean a significant impairment in everyday activities. It therefore appears crucial to record individual everyday tasks and their cognitive (and other) requirements in functional terms. This would also allow reliable assessment of the ecological validity of existing and insufficient cognitive skills. Understanding and dealing with the phenomena and consequences of mental aging does of course not only depend on cognition. Motivation and emotions as well personal meaning of life and life satisfaction play an equally important role. This means, however, that cognition represents only one, albeit important, aspect of mental aging. Furthermore, creating and development of proper assessment tools for functional cognition is important. In this contribution we would like to discuss some aspects that we consider relevant for a holistic view of the aging mind and promote a strengthening of a multidisciplinary approach with close cooperation between all basic and applied sciences involved in aging research, a quick translation of the research results into practice, and a close cooperation between all disciplines and professions who advise and support older people.

Re-orientating health and nursing care: a qualitative study on indigenous conceptualisations of wellbeing

BACKGROUND

Health systems often fail to address the wellbeing needs of older Indigenous populations; this is attributed to a lack of knowledge of Indigenous health systems arising from a privileging of dominant western biomedical epistemologies. In Aotearoa/New Zealand, there is a dearth of nursing knowledge relating to Māori, which negatively impacts on the provision of holistic nursing care. This research explores insights and perspectives of older Māori adult's (pakeke) perceptions of wellbeing so nurses can provide culturally responsive care and support the wellbeing of Indigenous New Zealanders.

METHODS

An Indigenous kaupapa Māori methodology underpinned and directed this research project. Audio-recorded interviews were conducted face to face in participants' homes, marae (meeting house) and workplaces. Pakeke over the age of 55 participated in in-depth interviews. A total of 10 pakeke were interviewed and narratives were thematically analysed in accordance with meanings derived from Māori worldviews.

RESULTS

Wellbeing was attributed to the holistic interconnection and balancing of whānau (wider family), whanaungatanga (social connectedness), hinengaro (mental and emotional wellbeing), taha tinana (physical wellbeing) and wairua (spirituality).

CONCLUSION

The findings offer unique insights into how wellbeing is constructed for pakeke; the results are unique but consistent with international accounts of older Indigenous peoples. Pakeke wellbeing can be supported by acknowledging existing cultural and spiritual beliefs and peer-support initiatives. Nursing models of care should prioritise Indigenous ways of knowing; this research offers nursing-focused recommendations to improve care.

Meaning in life and its relationship with family cohesion: A survey of patients with palliative care in China

OBJECTIVE

Meaning in life (MIL) and family cohesion are important concerns for the palliative care population; however, evidence of the relationship between MIL and family cohesion is scarce. Therefore, this study aimed to examine the relationship between MIL and family cohesion and explore the factors that influence MIL among the palliative care population.

METHODS

In this cross-sectional study, 205 patients with advanced cancer were recruited from two palliative care units in China. Data were collected using the meaning in life scale (MiLS), the family cohesion subscale of the Family Adaptability and Cohesion Scale, second edition, Chinese version, and the Karnofsky Performance Status Scale (KPS). Multivariate linear regression models were used to examine the relationship between family cohesion and perceived MIL and identify the potential factors of participants' MiLS score.

RESULTS

The mean MiLS score was 100.90 (SD ​= ​9.17). The results showed that family cohesion (r ​= ​0.313, P ​< ​0.001) and KPS scores (r ​= ​0.311, P ​< ​0.001) were positively correlated with MiLS scores. Multivariate linear regression revealed that MIL was significantly influenced by family cohesion, KPS score, sex, religiosity, whether participants lived alone, and their medical insurance payment method (Adjust R ² ​= ​28.4%, F ​= ​6.281, P ​= ​0.013).

CONCLUSIONS

Our findings indicate a positive relationship between family cohesion and MIL, suggesting that clinicians should consider increasing patients' family cohesion as an approach to enhance perceived MIL.

The Big Five Personality Traits and Positive Orientation in Polish Adults with Multiple Sclerosis: The Role of Meaning in Life

Scientific achievements concerning the direct relation between personality traits and positive orientation among patients with multiple sclerosis do not explain the role of potential mediators. In fact, some researchers argue that the traits–positivity association is much more complex than it seems to be. For this reason, we made an attempt to analyze the indirect relationship between the above-mentioned variables, including meaning in life as a mediator. In total, 618 patients with MS took part in the study. The NEO Five-Factor Inventory, the Positive Orientation Scale, and the Meaning in Life Questionnaire were used. The results showed that positive orientation/the presence of meaning/searching for meaning correlated positively with extraversion, openness to experience, agreeableness, and conscientiousness, and were negatively associated with neuroticism. Moreover, meaning in life in both its dimensions acted as a mediator in 9 of 10 models. It can be assumed that a propensity to establish interpersonal relationships (extraversion), use active imagination (openness), inspire confidence among others (agreeableness), and take responsibility (conscientiousness) can have an impact on someone’s positive attitude toward oneself and the surrounding world (positive orientation) when people have meaning in life and when they are seeking it.