Ego Integrity Research Articles

Residential treatment program outcome evaluation: one agency’s discoveries about performance measurement

ABSTRACT This paper explores the design and implementation of a comprehensive, continuous outcome evaluation for youth in therapeutic residential care (TRC) to measure program efficacy, based on The Joint Commission (TJC) accreditation guidelines. Over a 10-year implementation period, researchers analyzed changes in 281 residential care youth from baseline to reassessment after 4–6 months in treatment. The primary assessment instruments included the SASSI-A2, the FACES III, the Measure of Psychosocial Development (MPD), the Behavioral and Emotional Rating Scale (BERS), and the Youth Comprehensive Risk Assessment (YCRA). Results indicated reductions in the risk areas of self-harm, conduct disorder behaviors, and substance abuse. Significant increases occurred in psychosocial development, family engagement, and personal strengths. However, results also revealed continued low levels of youth development in trust vs mistrust, ego integrity vs despair, willingness to disclose loss of control, recognition of negative consequences of substance misuse, and response to conduct disorder treatments. Implications and recommendations for ongoing program evaluation, staff development, and institutional change are discussed.

제주 농촌 노인의 자아통합감 증진을 위한 회상기법 기반 집단상담 프로그램 개발

Objectives: This study aimed to evaluate the effectiveness of a reminiscence-based group counseling program to enhance ego integrity in elderly individuals living in rural areas of Jeju. The program sought to improve participants' psychological well-being and quality of life through reflective practices. Methods: For this study, an eight-session program was developed using reminiscence-based media, including salt, clay, and collage. The program encouraged participants to reflect on their life experiences, promoting emotional expression and introspection. Data were collected through participant feedback and psychological assessments before and after the intervention. Results: The results demonstrated significant improvements in ego integrity among the participants. Enhanced psychological stability and social integration were observed as a result of the supportive environment created in the group counseling sessions. Conclusions: Participants benefited from the program by fostering a greater sense of ego integrity, emotional well-being, and social support. The findings suggest that reminiscence-based group counseling can significantly contribute to the psychological health of rural elderly populations. Future studies should explore its long-term effects and broader applicability across diverse demographics.

A Study on the Analysis of the Recognition Factors of Good Death for the Elderly: Focusing on Acceptance of death, Death anxiety, Ego integrity

A Study on the Analysis of the Recognition Factors of Good Death for the Elderly: Focusing on Acceptance of death, Death anxiety, Ego integrity

2321 Therapeutic use of film screenings for care home residents: a scoping review

Abstract Introduction Symptoms of depression and anxiety, with and without dementia, are common in older care home residents. It is postulated that that watching films can help residents to share emotions, enhance social connectedness and engage in reminiscence. As such, films can ameliorate depression and promote well-being. This scoping review summarises the evidence for the therapeutic benefits of film-based interventions in care homes. Methods Electronic databases MEDLINE, Embase, EMCare and CINAHL were searched for quantitative and qualitative studies in English including adults aged 65 years and older in years 2005–2023. The search terms were: older adults, dementia, depression, carers, caregivers, care homes, and film. Results Five studies met our criteria: Campbell-Sills, 2006, USA; Kim, 2014, Korea; Davison et al., 2016, Australia; Bjornskov et al., 2018, Denmark; and Breckenridge et al., 2020, UK. All subjects were care home residents except for Bjornskov et al., who included 63 institutional caregivers. The number of study participants ranged from 11 to 120. There was a female predominance throughout the studies, and all residents had dementia of varying severity. Study designs included: direct comparison of participants with mood/anxiety disorder versus controls (Campbell-Sills); non-equivalent control group pretest/posttest (Kim); randomised single-blind crossover (Davison); qualitative focus-group caregiver interviews (Bjornskov); and cross-sectional observation (Breckenridge). Observation/follow up periods ranged from 6–10 weeks. Findings were as follows Campbell-Sills: residents with mood/anxiety disorders were identified by suppressing negative emotions induced by films; Kim: group reminiscence therapy using cinema increased ego integrity and reduced depression severity; Davison et al: using a personal computer platform that included films resulted in reductions in anxiety, depression and agitation; Bjornskov et al.: caregivers reported that films can evoke reminiscence; Breckenridge et al.: small-group film viewing enhanced social connectivity. Conclusions Film screenings for ageing care home residents have the potential for improving mood and encouraging social connections.

Relationship Between Nostalgia Proneness, Generativity, and Ego Integrity.

This study examined the effect of nostalgia proneness on the level of achievement of developmental tasks during the later stages of adulthood (generativity and ego integrity) and the indirect effect of nostalgia on ego integrity. The level of nostalgia proneness changes with age and contributes to subjective well-being in old age. We assumed that nostalgia proneness affects generativity and ego integrity. To confirm the causal relationship between nostalgia proneness and achievement of developmental tasks, a longitudinal study was conducted. We conducted an Internet survey twice with 600 Japanese adults (aged 20-87). The first and second surveys (T1 and T2) were conducted in March 2021 and March 2022, respectively. The questionnaire comprised the Inventory of Psychosocial Balance scale, positive/negative nostalgia proneness scale, and state functions of the nostalgia scale. An autoregressive path model indicated that high and low levels of positive and negative proneness, respectively, predicted ego integrity. The results of the mediation analysis suggested that social connections have an indirect effect on ego integrity and that people who tend to feel positive emotions are less likely to feel negative emotions when they remember nostalgic memories, which leads to a sense of social connection and the acquisition of ego integrity. The findings provide an understanding of the processes through which developmental tasks are facilitated in later adulthood and elucidate the efficacy of psychosocial interventions in older adults.

Effects of a Self-Transcendence Intervention Program on Self-Transcendence, Aging Anxiety, Sense of Well-Being, and Ego Integrity in Middle-Aged Women: A Randomized Experimental Study

Effects of a Self-Transcendence Intervention Program on Self-Transcendence, Aging Anxiety, Sense of Well-Being, and Ego Integrity in Middle-Aged Women: A Randomized Experimental Study

The Way Older Childless Women Value Their Life-A Qualitative Study.

Older women without children, like all older adults, evaluate their lives and face a conflict between despair and ego integrity as proposed by Erikson's theory of development. Their uniqueness lies in their deviation from the societal norm of parenthood prevalent in pro-natalist societies such as Israel. This study aims to explore how older childless women evaluate their lives. Using a qualitative approach, 20 semi-structured, in-depth interviews were conducted with women over 60 years of age who do not have children. Three main themes emerged from the participants' responses: their experiences as women without children in a pro-natalist society, the significance of freedom in their lives, and their life experiences from conflicting perspectives-an internal and external locus of control. The study's findings demonstrate that older childless women adeptly utilize different perspectives across various aspects of their lives, contributing to ego integrity, contrary to the prevailing societal notion that in the absence of children, women are damaged and lack identity. It is conceivable that other segments of the older adult population, diverging from mainstream societal norms, may similarly leverage these different perspectives to uphold their ego.

Effectiveness of Erikson's Ego Counseling as an Individual Counseling Approach

Erikson's ego counseling is an individual counseling approach based on Erikson's theory of psychosocial development. This approach views that individuals develop through eight stages of ego development. The goal of Erikson's ego counseling is to help clients achieve ego integrity by overcoming psychosocial crises at each stage of development. This research aims to analyze the effectiveness of Erikson's ego counseling as an individual counseling approach through a literature review. The method used is a systematic literature review of previous research on the application and effectiveness of Erikson's ego counseling. The results of the study show that Erikson's ego counseling is effective in helping clients overcome problems in achieving developmental tasks, identity crises, career stagnation, and other psychosocial problems. Erikson's ego counseling has also been proven to be able to increase the achievement of ego integrity. In conclusion, Erikson's ego counseling is an effective individual counseling approach based on the literature review conducted.

Relationship Between Life Satisfaction and Psychological Characteristics Among Community-Dwelling Oldest-old: Focusing on Erikson's Developmental Stages and the Big Five Personality Traits

ObjectiveTo clarify the relationship between life satisfaction and the psychological characteristics of the oldest-old, and explore the factors for achieving mental health and longevity. DesignThis cross-sectional study conducted questionnaire surveys and face-to-face interviews as part of a larger prospective cohort study. SettingArakawa Ward, a district in Tokyo, Japan. ParticipantsA total of 247 oldest-old individuals from two age groups, 85+ (aged 85–87 years) and 95+ (aged 95 years or older). MeasurementsLife satisfaction was assessed using the Satisfaction with Life Scale (SWLS), developmental stages of the elderly (Erikson's 8th and 9th stages, i.e., ego integrity, and gerotranscendence), and the Big Five personality traits (extraversion, agreeableness, openness, conscientiousness, and neuroticism) using the NEO-Five Factor Inventory. Multiple regression analyses were performed to examine the relationship between the SWLS scores and each assessment, controlling for age, sex, education, activities of daily living, depressive symptoms, and cognitive function. ResultsThe SWLS scores of 85+ were positively correlated with scores of ego integrity, extraversion, and conscientiousness. Contrastingly, the SWLS scores of 95+ were positively correlated with gerotranscendence scores. ConclusionsPsychological characteristics associated with the level of life satisfaction among community-dwelling oldest-old individuals were identified, but a causal relationship between these factors and life satisfaction was not established. Ego integrity, extraversion, conscientiousness, and gerotranscendence may be associated with enhanced life satisfaction and mental health in the oldest-old. Further, the factors associated with life satisfaction in the 85+ and 95+ age groups varied, suggesting that life satisfaction among the oldest-old has different foundations in different age groups.

FRI401 Co-creating Patient-facing Materials For Primary Ovarian Insufficiency

Abstract Disclosure: I.R. McDonald: None. E.S. Blocker: None. E.A. Weyman: None. C.K. Welt: None. A.A. Dwyer: None. Evidence suggests people with POI have unmet health and information needs that contribute to impaired health-related quality of life (HR-QoL). Co-creation can produce high-quality patient-facing educational materials that respond to patient-identified needs and overcome healthcare disparities. Our goal was to co-create patient-facing materials that respond to unmet health and informational needs, mitigate health disparities, and improve HR-QoL for people with POI. The project had three sequential steps. First, we synthesized the state of the science on HR-QoL, care, and management of POI. Next, we conducted a systematic scoping review to identify “best practices” for co-creating patient-facing materials. Last, we employed co-creation best practices, patient engagement, and an iterative “design thinking” process to co-create and evaluate patient-facing POI materials. The HR-QoL scoping review identified three inter-related themes related to impaired HR-QoL in POI (diagnostic odyssey, isolation & stigma, and ego integrity) along with sub-themes of decreased sexual function, altered body image, psychological vulnerability and catastrophizing. The co-creation scoping review identified 6 best practices for co-creation: (1) begin with a review of the literature, (2) utilize a framework to inform the process, (3) involve clinical and patient experts from the beginning, (4) engage diverse perspectives, (5) ensure patients have the final decision, and (6) employ validated evaluation tools. Informed by the synthesis of care and management of POI, we partnered with patients to create concise patient-facing materials responding to unmet health and informational needs of people with POI. Patients engaged in co-creation using the “design thinking” process: empathize, define the question, ideate/brainstorm, iterate prototypes (n=4), and testing using the “gold standard” Patient Education Materials Assessment Tool (PEMAT). The final 2-page patient-facing materials were evaluated using 7 readability algorithms revealing a consensus reading level of 7th grade (i.e., fairly easy to read for an 11-13 year-old). The patient partners rated the materials as highly acceptable and actionable. The online PEMAT evaluation is underway in collaboration with POI patient organizations. We envision such co-creation will produce understandable and actionable materials (i.e., all PEMAT domain scores >80%). This project may serve as a roadmap for healthcare organizations and patients to collaborate and surmount health disparities and improve care for other health conditions. Presentation: Friday, June 16, 2023

A study to assess the level of Ego integrity among Geriatric population residing in selected villages of Rural Health and Training Centre (RHTC), Pohir, Ludhiana, Punjab

Background: Ego integrity allows person to believe that life is meaningful even when physical ability declines. This belief allows person to accept that one’s life span is limited and face death as part of life. The tendency to review and restructure one’s past becoming more prominent in old age. Material and method: A quantitative research approach and non-experimental descriptive survey design was used to assess level of ego integrity. Data was collected from a sample of 340 geriatric population of selected villages of RHTC, Pohir, Ludhiana, by using convenience sampling technique. Responses were collected by interview schedule on Ryff and Heinicke Ego Integrity Questionnaire (1983). Data was tabulated and analyzed by using descriptive and inferential statistics. Result: The study revealed that majority 233(68.5%) of geriatric population were in the age group of 65-74 years, 185(54.5%) females, 334(98.2%) Sikh, 154(45.2%) illiterate, 242(71%) married, 292(86%) belonged to joint family, 163(47.9%) homemaker, 210(62%) living with spouse and children, 188(55.6%) independent, 228(67%) moves freely, 186(55%) chronically ill, 190(55.8%) had vision problem 107(31%) utilized their time with friends, 206(61%) participated in social activity and 192(56%) belonged to lower middle class. Conclusion: The present study concluded that most of geriatric population had high level of ego integrity. Most of them had acceptance of past as compare to satisfaction in life and fear of death. It was concluded that age, educational status, past occupation, presence of chronic illness and socio-economic status had its impact on ego integrity, further it was observed that those who participated in social activity had high level of ego integrity than those who did not participate in social activity.

The effects of ego integrity and readiness for death on the preferences of care near the end-of-life of hospitalized older adults in long-term care hospitals: A cross-sectional correlation study

Purpose: This study aimed to investigate ego integrity, readiness for death, and preferences of care near the end-of-life among hospitalized older adults in long-term care hospitals and identify factors that influence end-of-life care preference. Methods: A total of 181 older adults in long-term care hospitals participated in the study, and data collection was conducted from July 20th, 2020 to September 20th, 2020. Descriptive statistics, t-test, ANOVA, Pearson’s correlations, and multiple regression were used for data analysis. Results: The older adults in hospitalized in long-term care hospitals preferred pain management even at the risk of hastened death, while the least preferred option was autonomous decision-making, including artificially prolonging human life. Regarding end-of-life care preferences, ego-integrity (β=-.18, p=.004) and death-readiness (β=-.18, p=.005) were factors that only influenced the spiritual domain and in the pain domain, it was confirmed that only the ego-integrity (β=-.16, p=.013) was affected. Conclusion: Although ego integrity and readiness for death did not affect all areas of end-of-life care preference among older adults in long-term care hospitals, they represent significant variables denoting positive acceptance of death and life satisfaction. As such, it is necessary to provide various opportunities for these factors to be considered in the overall process of aging. Furthermore, it has been confirmed that other variables can influence each subdomain of end-of-life care preference. Therefore, nurses should support hospitalized older adults in receiving end-of-life care according to their preferred domains.

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Second Wind: Understanding How Academics from the Philippines Adjust to Retirement

Adventure and Spiritual Restoration: Older Adult Motivations for Undertaking a Pilgrimage on El Camino de Santiago

ABSTRACT A pilgrimage is an intentional journey undertaken for reasons that can increase a sense of well-being. Although originally completed for religious purposes, motives in contemporary times may include anticipated religious, spiritual, andhumanistic benefits as well as appreciation of culture and geography. This quantitative and qualitative survey research explored the motivations of a sample subset age 65 and over from a larger study who completed one of the Camino de Santiago de Compostelaroutes in Spain. Consistent with life course and developmental theory, some respondents walked at life decision points. The analyzed sample was 111 people, nearly 60% of whom were from Canada, Mexico, and the US. Nearly 42% were non-religious while 57% were Christian or a subset, Catholic. Five key themes emerged: challenge and adventure, spirituality and intrinsic motivation, cultural or historical interest, recognition of life experiences and gratitude, and relationships. In reflecting, participants wrote about sensing a call to walk and experiencing transformation. Limitations included snowball sampling, as it is difficult to systematically sample those who complete a pilgrimage. The Santiago pilgrimage counters a narrative of aging as diminishment through positioningidentity, ego integrity, friendships and family, spirituality, and positive physical challenge at the center of aging.

노인의 자아통합감과 죽음불안 및 사회적 지지 간의 상관관계

The purpose of this study is to identify the relationship between ego integrity, death anxiety and social support of the elderly. The subjects of the study were a total of 224 elderly people aged 65 or older living in 5 cities. The research method collected data using structured questionnaires, the collected data were analyzed using frequency, percentage, mean, standard deviation, t-test, ANOVA and Pearson correlation coefficient statistical techniques. The result of the study showed that there was a statistically significant negative correlation between ego integrity and death anxiety, and there was a significant positive correlation between ego integrity and social support. In conclusion, in order to improve the ego integrity of the elderly, it is necessary to lower death anxiety and increase social support. The results of this study can be used as basic data for subsequent studies related to the ego integrity of the elderly, and in the future, it is suggested to carry out research on the development of ego integrity improvement program considering the characteristics of the elderly residence type.

DEVELOPMENT AND VALIDATION OF THE FAMILIAL AGEISM SCALE

Abstract Researchers have found a tie between family relationships and the physical and mental health outcomes of older adults (Kelly et al., 2017; Silverstein & Giarrusso, 2010). Researchers have also established the negative impact of ageism on the physical and mental health of older adults (Chang et al., 2020; Lyons et al., 2018). However, studies studying the impact of ageism perpetuated by family members is relatively unexplored. This may be due to a lack of measures to assess ageism perpetuated by family members specifically. To address this gap, the goal of the current study was to design a tool to measure experiences with familial ageism. Scale items were created based on the review and analysis of qualitative data on this topic (Walker & Kinkade, in prep). Items were reviewed by scholars for content and clarity. Two studies were then conducted to develop and validate our measure to assess experiences with ageism within the family context. In the first study, 151 participants completed the familial ageism items. The factor structure, convergent and divergent validity of the items were examined. We found evidence of strong psychometric properties for five related, but unique, factors in the retained items: Benevolent Ageism, Technological Competency, Out of Touch, Aging Appearance, and General Competence. Construct, convergent, and divergent validity was supported with small to large correlations with scales measuring general ageism, depression, and ego integrity. A second study with 282 participants confirmed the five-factor structure. Implications and recommendations for scale utilization will be discussed.

LIFE LESSONS: THE EXPERIENCES OF OLDER ADULTS LIVING IN PUERTO RICO DURING COVID-19

Abstract What life lessons emerge from a group of older Puerto Ricans concerning their experiences with COVID-19. We will review study participants’ reports of how they spent their time during the pandemic, what they found most difficult to cope with, and life lessons they learned as a result. We will use Erickson’s life course theory of psychosocial development to frame their responses to these questions, including the crises (and strengths) of generativity versus stagnation (care) and ego integrity versus despair (wisdom). We will report evidence of care and wisdom as core ego strengths resulting from their lived experience. We will also review how isolation, sense of community, and key mental and physical health factors seemed to influence how their responses suggest coping strengths. We will discuss our findings in the context of social and cultural norms of current cohorts of older Puerto Ricans, highlighting the salience of community and family relations. (150 words)

THE RELATION BETWEEN DEATH PREPARATION AND LIFE SATISFACTION AMONG KOREAN OLDER ADULTS

Abstract Objectives There is a growing interest in death preparation as an important process to achieve ego integrity at the last stage of life. However, in South Korea, conversations about death remain taboo especially with older adults. Thus, this study aims to examine the association between preparation for one’s death and life satisfaction among Korean older adults. Methods Data for this study were drawn from the 2020 National Survey of Older Koreans conducted by the Korean Ministry of Health and Welfare. The sample was limited to adults aged 65 and older (N=10,097). The survey measured preparation for death, life satisfaction, and various covariates (e.g., sociodemographic characteristics, physical conditions, psychological conditions). Hierarchical multiple regression analysis was used to examine whether death preparation influences life satisfaction among Korean older adults. Results Results from hierarchical multiple regression showed that after adjusting for covariates, those who reported more preparations for death mentally (B=.054, p<.001) and materially (B=.035, p<.001) were more likely to have greater satisfaction in life than their counterparts. Conclusion Findings suggest that it is necessary to generate proper information and recognition about death at the government level and activate discourses on death preparation in later life.

Merajut Hidup Bahagia dan Bermakna pada Lansia melalui Reminiscence Therapy

The elderly have many decreased abilities in many aspects of their development, therefore they have limitations in their activities and social interactions in meeting their needs. Those limitations make the elderly feel useless and worthless which may evoke anxiety, stress, and even depression. This study aims to determine the process and the advantages of reminiscence therapy in increasing the happiness and meaning in life in elderly people. The method used in this empirical investigation was literature study, namely by filtering several published scientific articles which are related to the topic of this study. 72 articles relevant and published between 2012 and 2022 were found. The result of the literature study shows that reminiscence therapy is a therapeutic process that guides elderly people to review their past positive and negative experiences, and then they interpret and take lesson from all those events to build a positive view and acceptance towards themselves. This will be able to increase the happiness and meaning in life in the elderly until ego integrity is achieved.Keywords: Elderly, Happiness, Meaning in life, Reminiscence Therapy.

Emotional intelligence predicting ego integrity in healthy older adults

Objectives A characteristic task in aging is the process of reevaluating and reflecting on one’s life in order to give it meaning. The successful resolution of this task is defined as ego-integrity, and it is related to various psychological phenomena that foster the person’s adaptation to change. The objective was to adapt an ego-integrity scale in a sample of older adults and study the relationships between emotional intelligence, coping strategies, and mood to find out whether they are predictors of ego-integrity. Methods The sample included 401 healthy older adults (241 women; ages 65–95, M = 73.69, SD = 6.83). Statistical analyses included structural equation models. Northwestern Ego-integrity Scale 9-item was tested showing that a structure with two unrelated factors fitted the data well. The internal consistency was satisfactory (.82 integrity and .72 despair). Results Emotional intelligence positively predicted problem-focused adaptive coping strategies (problem solving and positive reassessment) and negatively predicted state of mind (depression and hopelessness), whereas adaptive coping positively predicted integrity, and mood predicted it negatively. Conclusion Emotional intelligence skills, adaptive coping strategies, and mood largely determine the successful resolution of the ego integrity conflict and are relevant resources in successful aging.