Nurses’ Perception of Factors that Affect Social Engagement among

Older Person in the Community

Chong Mei Chan

, Amirah Fatin

2,3

, Thandar Soe Sumaiyah Jamaludin

and Vimala Ramoo

Department of Nursing Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia

Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya

Department of Medical-Surgical Nursing, Kulliyyah of Nursing, International Islamic University Malaysia, Jalan Hospital

Campus, Kuantan, Pahang, Malaysia

Keywords: Social Engagement, Older People, Factors, Nurses.

Abstract: Nurses who are working with elderly play an important role in promoting social participation among the

senior resident in the community, their perception towards elderly isolation is crucial in order to guide them

in shaping their role. The nurses’ perception of social isolation among elderly in the community was

explored through a descriptive qualitative research approach. A focus group interview were used to collect

data from 10( into two group ) register nurses who work with older person in the community setting. Non

probability, purposive sampling were used to recruit participants. The data were collated and thematically

code, analyse and then present. Data were categorised into themes as they emerged. Six main themes

derived from this focus group interview, These were: socio-environmental, health status, interpersonal

relationship, Personality and cultural and Financial status. Social engagement among older person is

affected by socialisation among the older community. Sharing same cultural and religious practice may

enhance social connection among the older person. Health care provider should plan short term strategies to

enhance participation in communities and should consider long term plan to empower them.

1 BACKGROUND

Social engagement has been associated with

successful aging (Depp & Jeste, 2006). Rowe and

Kahn’s (1998) described social engagement as

‘remaining involved in activities that are meaningful

and purposeful’ and ‘maintaining close

relationships. Emphasis should be made in

establishing friendship in senior housing, and

encourage the older adults to remain closely

connected to more established groups of friends and

family who live in the community. It is imperative to

establish adequate policies that could support the full

inclusion and participation of older adults in society

to enhance high quality of life for our aging

population (Robert, 2014).

The prevalence of social disengagement in

Malaysia is rampant among older people. There are

many factors influence the social engagement most

of the previous studies has explore on the older

people perception on social disengagement, but very

limited study has explore the nurses’ perception on

social disengagement among older people which is

consider crucial as nurses perception is important in

order to plan the actual care for the older people

especially in community setting. Hence the aim of

this paper is to present the finding from a focus

group with nurses from community based setting.

2 METHODS

The design for this study is qualitative design using

focus group discussion. Purposive sampling was

used to recruit 10 nurses who were working in the

community setting in an urban area of Malaysia. All

participants were female. The mean age was 36

years old. They were all master students at the time

of undertaking this project. All the participants were

able to speak English and Bahasa Melayu well.

Briefing was given to the entire participant prior

to FGD session. Consent for participation was

obtained from all participant and they were allowed

to withdraw at any time and confidentiality maintain

and they were told their name will be kept

anonymous. Conducive room was identified to

Chan, C., Fatin, A., Jamaludin, T. and Ramoo, V.

Nurses’ Perception of Factors that Affect Social Engagement among Older person in the Community.

DOI: 10.5220/0008322001570160

In Proceedings of the 9th International Nursing Conference (INC 2018), pages 157-160

ISBN: 978-989-758-336-0

157

conduct the FGD. An interview guide was prepared

to guide the FGD session.

The data of focus group was transcribed into

verbatim. Open coding began during data collection

and transcription. The process of data analysis

included coding, categorization and compression

(Miles, et al.,2014). It was conducted by experienced

researchers, namely the primary investigator and co-

investigator. The data was presented to the

participants, the primary investigator for cross

checking. The data was organized using NVivo

computer software.

The themes surfaced from data analysis were

cross checked with WHO’s Global aged-friendly

cities: A guide. Meanwhile, to understand older

people, who were born in different generations and

cultural backgrounds, required understanding the

cultural development which shaped their belief and

perception of life.

3 RESULTS

Six main themes derived from this focus group

interview, these were: 1) socio-environmental, 2)

health status, 3) interpersonal relationship, 4)

Personality and 5) cultural/religion and 6) Financial

status. Each main theme is presented with

subthemes.

1. Socio environmental

▪ amenities and facilities

▪ transportation

▪ social safety

▪ social activities (park dancing, qi gong)

2. Health status

▪ immobility

▪ Eye and muscle wastage.

3. Iinterpersonal relationship

▪ family structure

▪ mutual support from family member, spouse

▪ friendship

▪ Motivation from community figure head.

▪ support from community health care worker

▪ social media. whatapp, face book)

4. Personality

▪ positive thinker

▪ passive

▪ Keep going

▪ permissive

▪ happy go lucky

▪ autonomy

5. Cultural/religion

▪ religious (close to god)

▪ socialisation culture (melepak)

▪ window shopping

▪ chatting among neighbourhood.

▪ “gotong –royong (group activities)

4 DISCUSSION

The factors affecting social engagement among

older people in an urban area of Malaysia as

perceived by the nurses were consistent with the

WHO’s Global Aged-friendly Cities Guide, namely

the availability of facilities, transportation, activities

(which the seniors can gain information easily),

close proximity, affordable activities, variety of

choices for activities, having companies, health and

interaction with neighbours. Nurses felt family

support, such as spouse and family member support,

would affect social engagement.

The nurses place social environment as key

determinant for older persons’ engagement with

society, such as amenities and facilities,

transportation, social safety and social activities

(park dancing, qi gong). Unfortunately impede

social; environment may indirectly hinder social

participation among older folks, for example

inconvenient transportation services where older

people are relying on others to move about. Another

issue is vandalism. There is a lack of care for public

facilities. the environment are not friendly to older

people According to National Older Persons Policy

(2011), Malaysian government is committed to

creating friendly service and conducive living

environments for older persons (Department of

Social Welfare Malaysia ,2011).

Interpersonally relationship may affect the social

engagement of older person as highlighted by the

nurses. According to Lim (2005) the older persons

and immediate family may have ambivalent feelings

between generations as a result of social changes,

prevalent of nuclear families and work nature of

younger generations. However the nurses form this

study reported that the older person from their

community was well supported by their family

member and most of them were staying with their

children. Most of them have positive thinking and

paly active role in helping their children who are

working. According to the nurses the family support

have enable them to participate actively. They are

few comments on the negative side of family

support which refrain older people from engaging to

society, for example who had lower socio economic

status and depending on their children. Especially

female older were preferred to remain quiet and

tolerate with their children to maintain harmony

with family relationship. Thus family support does

INC 2018 - The 9th International Nursing Conference: Nurses at The Forefront Transforming Care, Science and Research

158

play key role in motivate the social engagement

among older persons

One of the example is figure head (community

leader) from the community to certain extend may

have influence in encouraging social engagement by

initiation of community activities. Support from

support from community health care worker was

viewed by nurses as important measure to the older

community as most of them had deterioration in

health status with immobility due to vision and

muscle wasting.

The nurses also found social media such as

whatsApp and face book has created opportunity to

promote social engagement among the older

community, the keep connecting via chat group and

with family members.

The nurses’ understanding on patterns of social

engagement among older people from different

social economic status would shape the influence of

cultural values that would guide the behaviours.

There were few unique culture and religion

influence surface from the focus group. As family

structure reforms as most of the children are

working away from their parents’ home, older

people may need to migrate to a difference town to

stay with their children or remain at home town.

Migration may cause isolation to older people, as

the social connectivity may be less when compare to

rural area.

Two Malaysian studies had revealed that social

changes may have negative impact on cultural

values and the need for social engagement(Ong, et

al., 2009 and Tey, at al., 2015). The nurses from this

study felt religious would allow the older people to

socialise with the community when they are

engaging with religious activities. In some

community the older people socialisation cultures

were having fun time melepak (meeting and chatting

with friends at the restaurant or coffee shop).

Female older persons like to have “window

shopping” or have fun doing marketing with their

neighbourhood friends. The community folks were

fond of doing activities together (gotong –royong),

the older people were willing to help each other for

activities like organising event or celebration.

Many studies has highlighted that sense of

autonomy is essential older person to having cope

with changes in later life stages(Wahl, et al., 2012,

Greenfield, 2015 and Powell, 1985). In this study,

the nurses explained that some female older people

with low education seemed to be less autonomous

to take charge and to initiate activities or engaging

with society. The low level of autonomy in them

has make them more acceptance top down

instruction Lacking of autonomy to take charge

could be a cue of colonial influence (Hirschman,

1986, Shamsul, 2001)

The implication of lacking of autonomy has far

more implication than just older person’s care. It

imply for more caring society to nurture generation

with more autonomy and prepare a more

autonomous older persons in future. Autonomy

comes with empowerment and acquisition of

knowledge. Perhaps the health care provider will be

able to foster empowerment to the older people in

particularly in motivation social engagement and

maintaining health.

Personality of older people may influence the

their willingness to engage with society and more

tolerance, for example older people who are more

positive thinker, who are keep going and happy go

lucky were those older people who are active in

community. Unlike older people especially older

female were passive and permissive had better

tolerance as described by the nurses that remaining

silent or avoiding conflict were coping mechanism

for older people to live harmony within the multi

generation differences .

5 CONCLUSIONS

The nurses from this study had identified many

factors affecting the level of engagement among

older people. The implication of this study has

enlightened the community as whole the macro and

micro systems of a society are interrelated.

16,23

Promoting a considerate cultures in all levels of

society is fundamental to create friendly and

conducive environments for all people especially for

older people. It is also crucial to inculcate sense of

responsibility among community members to safe

guard the amities and facilities. Appropriate and

relevant intervention and monitoring shall be

implemented to ensure the older people are able to

cope with their later life and maintain a good quality

of life and engaging with society.

ACKNOWLEDGEMENTS

This work is supported under Grand challenge PISA

[GC002C-14HTM].

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