روش مدیریت استرس از جامعه خانه سالمندان در هنگ کنگ: مفاهیم برای دوخت یک برنامه کاهش استرس

This study aims to explore the preferences of the elderly in adopting five stress-management methods and to identify the reasons for nonadoption. A convenience sample of 212 community-dwelling elders age 60 or older was obtained from four multiservice centers for the elderly in Hong Kong. The findings suggest that the elderly prefer to manage stress on their own rather than rely on social support from family, friends, and professionals. The notion of saving face in the Chinese culture and an inadequate supply of social support are possible explanations why the elderly do not like to seek help from others to reduce stress. This study offers a model for a stress-reduction program for community-dwelling elderly people in Hong Kong to enhance their ability to cope with stress.

This descriptive survey had a convenience sample of 212 elderly people, age 60 or older, without speech, hearing, or cognition impairments who were recruited from four multiservice centers for the elderly in Hong Kong. The centers are non-government organizations, which are subsidized by the government to provide social and recreational activities, counseling, home help, meals, bathing and laundry facilities, and health education services for community-dwelling elders 60 or older.22 After obtaining informed consent, the researchers collected data through face-to-face interviews with each participant. The instrument for this study included five dichotomous questions and six open-ended questions (Table 1). The first five questions measured whether the subjects had adopted any of the five stress-management methods when they encountered stressful events. The dichotomous format of questions is comparatively suitable for collecting data from a sample of elders who have slower cognitive functioning and a lower ability to think abstractly. One open-ended question was used to identify other stress-management methods, while five additional open-ended questions were designed to identify the reasons reported by subjects who did not use the five identified methods.

In summary, the community-dwelling elderly prefer to manage their stress on their own rather than rely on support from family, friends, professionals, and religion. The findings led the researchers to tailor a stress-reduction program for nurses to help Hong Kong's community-dwelling elders enhance their ability to cope with stress. The program aims to enhance elders' abilities to manage stress and help them seek assistance when necessary. Training in relaxation exercise and the introduction of cognitive coping methods are the core activities in the program for the elderly to manage stress without assistance. Out of cultural considerations, tai-chi exercise is included in the program rather than progressive muscle relaxation or imagined muscle-relaxation exercises. However, tai chi should be modified to reduce the complexity of the movements for the elderly. The cognitive coping method, which involves thoughts and cognition, is introduced in the program to teach elders how to regulate the emotions induced by stress through acceptance, rumination, positive reappraisal, and refocusing on planning for negative life events. The religion, beliefs, and values of the elderly participants should be assessed and used to influence their thoughts and cognition as part of the introduction of this method to enhance its effectiveness. Some elders use negative methods of stress reduction, such as drinking and smoking, and they may not be able to manage their stress effectively without assistance from others. Therefore, the following activities for enhancement of social support are also included in this program. Nurses must not force elders to receive help from others, but they can advise elders of the importance and effectiveness of social support from family, friends, and professionals in stress management and the sources of assistance in managing stress. Nurses should encourage elders to seek help in times of difficulty and anxiety that they cannot manage on their own. Furthermore, elders should be encouraged to share, in small groups, their experiences to enhance social support and minimize the barriers to seeking this support.