Ethical Issues in the Selection of a Theoretical Framework for Gerontological Nursing Research

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Abstract
The articles prior to January 2008 are part of the back file collection and are not available with a current paid subscription. To access the article, you may purchase it or purchase the complete back file collection here Patricia G Archbold, RN, DNSc Activity Theory In diametric opposition to disengagement theory, activity theory postulates that successful aging is characterized by active engagement in social interaction and replacement or maintenance of middleaged roles. Assumptions. One assumption of activity theory is that the older person benefits from being engaged actively in social roles. Another assumption is that all activities are of equal value, avoiding the issue of the meaning of work. Influence on problem identification. Research questions derived from activity theory center around the activities of older persons from the standpoint of their involvement, motivational factors related to their involvement, the development of age-appropriate activities, and the correlation of activity involvement with morale and mental health. Foci of study avoided by the theory. Several crucial variables influencing the participation of the elderly in activities are not considered in activity theory. For example, the theory fails to consider individual variations in participation in activities throughout the life cycle. Is it possible to consider active participation in social activities asa measure of successful aging for a person who has never been an participant? Ill health and frailty, especially common in persons older than 75 years of age, hamper the individual's ability to participate in activities. In addition, depression and the reaction to losses common to older persons are common barriers to active engagement in social roles. An important consideration is whether the individual has adequate financial resources for participation. As mentioned earlier, retirement often is accompanied by significant loss of income. Participation in many highly valued activities is predicated on their being affordable. The elderly on fixed incomes frequently have difficulty meeting financial demands of the essential needs for food and shelter, let alone those for entertainment and social activity. Often environmental barriers prevent the elderly from participation in activities. The lack of adequate public transportation in many communities and the mobility limitations many elderly prevent them from using existing poorly designed public transportation vehicles. Another issue avoided by the framework is the class bias in role replacement. It is generally understood that continuation or replacement of roles is easier for middle class clients, those who had the luxury of developing avocations early in life, or those for whom mandatory retirement policies do not apply Finally, the nature of many institutions for the ill elderly (nursing homes, board and care facilities, etc.) mitigate against their participation in any activity. Lack of programming, lack of staff, and structural barriers facilitate disengagement. Implications for practice and research. Nurses using activity theory develop a' range of activities for their older clients and universally encourage their participation. The theory allows for more client participation in decision making than does disengagement theory. Gerontological texts suggest alternative activities for clients, including group work, participation in music, dance, and current events programs, and remotivation therapy. Some observations of a good nursing home demonstrate the potential misuse of activity theory. The employees in the home believed that active engagement in the community (home activities) was necessary for the "good life." Consequently, clients were encouraged to attend and participate in the numerous activities available. One woman resident indicated her reluctance to join a large group meeting. She was encouraged (to the point of coercion) to attend. After half an hour, the woman had an attack of anxiety for which she required sedation. This example illustrates that negative sanctioning for nonparticipation in activities can be very dangerous for the vulnerable elderly. Policy consequences. Activity theory emphasizes programs for the "healthy aged." In doing so, it has contributed to decreasing the negative stereotypes of the aged. However, the theory ignores, for the most part, elderly who are infirm… 10.3928/0098-9134-19810701-07

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