Comparisons of the Effects of Physical Activity and Perceptions of Aging on the Perspective of Healthy Aging among Older Persons with Chronic Disease Living on Cross-Taiwan Strait

Abstract

Background The World Health Organization proposes that among global aging-related issues special attention should be paid to the concept of healthy aging and aging perception For older adults the concept of being healthy is no longer linked with having any disease but with what the elderly need to face and their self-regulation in the aging process for the reduction of the risk of death and improvement of their quality of life The societies of Taiwan and China are also faced with the impact of aging They are different in terms of political system culture health care model and medical insurance system and their concepts of healthy aging and aging perception might be different and further the care for older persons with chronic diseases might also be different Purpose The purpose of this study was to investigate the differences in the perception of aging and physical activity in the perspectives of healthy aging among older people with chronic diseases on both sides of the Taiwan Strait At the same time this study also understood the predictors and mediation effects that affected healthy aging perspectives Methods This was a descriptive study with a cross-sectional study design Participants in this study were older persons aged over 60 with chronic diseases Older people in Tainan City Taiwan and Ningbo City Zhejiang Province China were invited These participants were recruited from the outpatient department of medical centers and community health service centers located in the two cities The research instruments contained personal characteristics Brief Ageing Perception Questionnaire Chinese version (B-APQ-C) Physical Activity Scale for the Elderly (PASE) and Health Aging Perspectives Questionnaire (HAPQ) The psychometric testing of the scales was first completed followed by face-to-face interviews with the participants for data collection A total of the 420 questionnaires and 408 questionnaires were recruited in Taiwan and China respectively with 415 valid ones returned in Taiwan (response rate= 98 80%) and 400 in China (response rate= 98 04%) Statistical analyses including independent T-test chi-square test Pearson correlation one-way ANOVA multiple regression and mediation analysis were conducted by using SPSS 17 0 Results The average age of older people living on both sides of the Taiwan Strait was 71 43 years old (SD= 9 07) with two types of chronic disease (SD= 1 03) in average Compared with older adults with chronic diseases between Taiwan and China Taiwanese older people were significantly heavier in body weight (BMI men's and women's waist circumference) and had poorer control of blood pressure than the Chinese counterpart For the healthy lifestyle higher proportion of elders in China had smoking drinking unbalanced diet and poorer appetite than older adults in Taiwan When it comes to the living patterns the older people in Taiwan mostly lived with their children and older persons in China mostly lived with their spouses In term of aging perception it was found that t the Taiwanese elderly were significantly higher in the Time-line chronic Consequences positive Negative aging emotional control and consequences the Chinese older people had significantly higher results in Control positive In addition the older people in Taiwan had significant higher work and overall physical activity than those of the older adults in China In the perspectives of healthy aging it was found that Lifestyle created by the disease and Changes in family life caused by disease were significantly better in Taiwanese older people Results of hierarchical regression analysis indicated that smoking balanced diet nutritional supplements all the variables of perception of aging and Health-related changes could predict 38% variance of the healthy aging perspectives In Taiwan the predictors included waist circumference balanced diet nutritional supplements Time-line chronic Consequences positive Negative aging emotional control and consequences and leisure activities; and the explanatory variance of the model was 50% In China the main predictors of healthy aging perspectives in older people with chronic diseases included smoking appetite status nutritional supplements Time-line chronic Consequences positive Control positive and Health-related changes caused by aging which could explain 28% of the variance In the multiple mediation analysis after controlling the chronic disease of the older adults on both sides of the Taiwan Strait the effects of age on aging perception and physical activity on healthy aging perspectives were completely intermediary indicating that the older the age the lower the perception of aging and physical activity leading to the worse healthy aging perspectives Conclusion and Recommendations This study investigated the effects of the perception of aging and physical activity of the older persons on healthy aging perspectives among both sides of the Taiwan Strait The research results showed the perception of aging significantly impact on the perspective of healthy aging among older people with chronic disease Although older people with chronic diseases on both sides of the Taiwan Straits share different living environments they all need routine treatment of their chronic illness to maintain their health At the same time when they have above moderate ageing perceptions they would have better healthy aging perspectives We recommend psychological health screening and interventions on promoting positive aging perception and physical activity motive should be incorporated to their care plan in order to enhance their perspectives of healthy aging and further to improve their quality of life

Date of Award	2020
Original language	English
Supervisor	Ching-Min Chen (Supervisor)