| 1. |
- Lundman, Berit, et al.
(författare)
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Development and psychometric properties of the Inner Strength Scale
- 2011
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 48:10, s. 1266-1274
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Four dimensions of inner strength were previously identified in a meta-theoretical analysis: firmness, creativity, connectedness, and flexibility.OBJECTIVE: The aim of this study was to develop an Inner Strength Scale (ISS) based on those four dimensions and to evaluate its psychometric properties.METHOD: An initial version of ISS was distributed for validation purpose with the Rosenberg Self-Esteem Scale, the resilience scale, and the sense of Coherence Scale. A convenience sample of 391 adults, aged 19-90 years participated. Principal component analysis (PCA) and confirmatory factor analysis (CFA) were used in the process of exploring, evaluating, and reducing the 63-item ISS to the 20-item ISS. Cronbach's alpha and test-retest were used to measure reliability.RESULTS: CFA showed satisfactory goodness-of-fit for the 20-item ISS. The analysis supported a fourfactor solution explaining 51% of the variance. Cronbach's alpha on the 20-item ISS was 0.86, and the test-retest showed stability over time (r=0.79).CONCLUSION: The ISS was found to be a valid and reliable instrument for capturing a multifaceted understanding of inner strength. Further tests of psychometric properties of the ISS will be performed in forthcoming studies.
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| 2. |
- Viglund, Kerstin, 1958-
(författare)
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Inner strength among old people : a resource for experience of health, despite disease and adversities
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background Inner strength has been described as an important phenomenon in association with disease management, health, and ageing. To increase the knowledge of the phenomenon of inner strength, a meta-theoretical analysis was performed which resulted in a model of Inner Strength where inner strength comprises four interrelated and interacting dimensions; connectedness, creativity, flexibility, and firmness. The model was used in this thesis as a theoretical framework.Aim The overall purpose of this thesis was to develop and validate an inner strength scale, describe inner strength among an older population, and elucidate its significance for experience of health, despite disease and adversities.Methods The studies had quantitative approaches with cross-sectional designs (I-III) and a qualitative approach with narrative interviews (IV). Studies I-IV was part of the GErontological Regional DAtabase (GERDA) Botnia project. In study I, the participants (n = 391, 19-90 years old) were mostly from northern Sweden. In studies II and III, the participants (n = 6119, 65, 70, 75 and 80 years old) were from Sweden and Finland, and in study IV the participants (n = 12, 67-82 years old) were from Västerbotten County. Data was analysed using principal component analysis and confirmatory factor analysis (CFA), various statistics, structural equation modelling, and qualitative content analysis.Results In study I, the Inner Strength Scale (ISS) was developed and psychometrically tested. An initial 63-item ISS was reduced to a final 20-item ISS. A four-factor solution based on the four dimensions of inner strength was supported, explaining 51% of the variance, and the CFA showed satisfactory goodness-of-fit. In study II, ISS scores in relation to age, gender and culture showed the highest mean ISS score among the 65-year-olds, with a decrease in mean score for every subsequent age (70, 75, and 80 years). Women had slightly higher mean ISS scores than men, and there were minor differences between the regions in Sweden and Finland. In study III, a hypothesis was proposed and subsequently supported in the results where inner strength was found to partially mediate in the relationship between disease and self-rated health. The bias-corrected bootstrap, estimating the mediating indirect effect was significant and the test of goodness-of-fit was satisfactory. In study IV, from the narratives of inner strength it was found that inner strength comprised feelings of being connected and finding life worth living. Having faith in oneself and one’s possibilities and facing and taking an active part in the situation were also expressed. Finally, coming back and finding ways to go forward in life were found to be essential aspects of inner strength.Conclusions The newly developed ISS is a reliable and valid instrument that captures a broad perspective of inner strength. Basic data about inner strength in a large population of old people in Sweden and Finland is provided, showing the highest mean ISS score among the 65-year-olds. Inner strength among old people is a resource for experience of health, despite disease and adversities. This thesis contributes to increase knowledge of the phenomenon of inner strength and provide evidence for the importance of inner strength for old people’s wellbeing. Increased knowledge of the four dimensions of inner strength; connectedness, creativity, flexibility and firmness, is proposed to serve as an aid for health care professionals in their efforts to identify where the need of support is greatest and to find interventions that promotes and strengthen inner strength.
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| 3. |
- Viglund, Kerstin, et al.
(författare)
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Inner strength among old people who have experienced a crisis in life
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Inner strength is a resource associated with health and disease management. Our objective was to elucidate inner strength in the narratives of people 65 years and older who had experienced a crisis in life associated with a disease. They had self-rated their inner strength as high, and qualitative content analysis was used in the interpretation of the narratives (n = 12). In the narratives, we found that inner strength comprised feelings of being connected and finding life worth living. Having faith in oneself and one’s possibilities and facing and taking an active part in the situation were also expressed. Finally, coming back and finding ways to go forward in life were found to be essential aspects of inner strength.
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| 4. |
- Viglund, Kerstin, et al.
(författare)
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Inner strength as a mediator of the relationship between disease and self-rated health among old people
- 2014
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Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 70:1, s. 144-152
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore inner strength as a mediator of the relationship between disease and self-rated health among older people.BACKGROUND: Qualitative research has indicated that inner strength is an essential resource for an individual affected by disease. A hypothesis of inner strength as a mediator of the relationship between disease and self-rated health was proposed. The theoretical framework of inner strength was based on the Model of Inner Strength.DESIGN: A cross-sectional design was used.METHOD: The sample included 6119 participants from Finland and Sweden, in the ages of 65, 70, 75 and 80 years. The GERDA-Botnia questionnaire, which included the Inner Strength Scale and items related to diseases and self-rated health, was sent out between October and December 2010. Structural equation modelling was used to test a hypothesized model.RESULTS: The result indicated that having a disease was associated with poorer self-rated health and a lower degree of inner strength and a higher degree of inner strength was associated with better self-rated health. The result supported the hypothesis by indicating that inner strength partially mediated the relationship between disease and self-rated health.CONCLUSION: This large cross-sectional study with participants from 65 to 80 years of age from Finland and Sweden showed that inner strength can be a resource for older people affected by disease. Increasing inner strength in older people affected by disease may be one intervention to support experiences of health despite disease.
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| 5. |
- Viglund, Kerstin, et al.
(författare)
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Inner strength in relation to age, gender and culture among old people : a cross-sectional population study in two Nordic countries.
- 2013
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Ingår i: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 17:8, s. 1016-1022
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The theoretical framework for the study was the Model of Inner Strength, and the Inner Strength Scale (ISS)developed based on the Model was used. The aim was to examine inner strength in relation to age, gender and culture among old people in Sweden and Finland.Method: This study forms part of the GErontological Regional DAtabase (GERDA)-Botnia project that investigates healthy ageing with focus on the dignity, social participation and health of old people. The participants (N = 6119) were 65-, 70-, 75- and 80-year old and living in two counties in Sweden or Finland. The ISS consists of 20 items relating to four interrelated dimensions of inner strength, according to the Model of Inner Strength. The range of possible ISS scores is 20-120, a higher score denoting higher inner strength.Result: The result showed that the 65-year-old participants had the highest mean ISS score, with a decrease in score for every subsequent age. The lowest score was achieved by the 80-year-old participants. Women had slightly but significantly higher mean ISS scores than men. Only small differences were found between the counties.Conclusion: The study population came from Sweden and Finland; still, despite the different backgrounds, patterns in the distribution of inner strength were largely similar. The present study provides basic and essential information about inner strength in a population of old people.
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| 6. |
- Viglund, Kerstin, et al.
(författare)
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Psychometric properties of the Swedish version of the selection, optimization, compensation questionnaire
- 2013
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Ingår i: Scandinavian Journal of Caring Sciences. - Hoboken : Wiley-Blackwell. - 0283-9318 .- 1471-6712. ; 27:2, s. 460-467
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Tidskriftsartikel (refereegranskat)abstract
- Background: The model of selection, optimization and compensation has been proposed as a model of adaptive management strategies throughout the lifespan.Aim: The aim of this study was to test the psychometric properties of a translated Swedish version of the 12-item selection, optimization, and compensation (SOC) questionnaire.Method: The 12-item SOC questionnaire is composed of four subscales: elective selection (ES), loss-based selection, optimization and compensation. A convenience sample of 122 Swedish-speaking people, aged 19-85, participated in a study of the validity and reliability of the SOC questionnaire. Cronbach's alpha coefficient, corrected item-total correlation and Cronbach's alpha if item deleted were used for reliability testing. Two other scales, the ways of coping questionnaire and Rosenberg's self-esteem scale, were used to test convergent validity, and the geriatric depression scale was used to test discriminant validity. Stability over time was evaluated using a test-retest model with a 2-week interval.Results: The 12-item SOC questionnaire showed a Cronbach's alpha value of 0.50, and the subscales ranged from α=0.16 to α=0.64. Two items in the ES subscale had negative values on the corrected item-total correlation and showed substantial improvement (>0.05) in Cronbach's alpha when item deleted. When these two items that influenced internal consistency were deleted, Cronbach's alpha rose to 0.68.Conclusion: The Swedish version of the 12-item SOC questionnaire showed deficiencies in a test of internal consistency because of two items in the ES subscale, and these two items were deleted. A consequence of the reduction is a weakening of the ES subscale and thereby to some extent the SOC questionnaire in total. Further testing is advisable. However, the 10-item SOC questionnaire was acceptable in a test of validity and reliability.
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| 7. |
- Viglund, Kerstin, et al.
(författare)
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Relationships among inner strength, health and function, well-being, and negative life events in old people : a longitudinal study
- 2022
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Ingår i: European Journal of Ageing. - : Springer. - 1613-9372 .- 1613-9380. ; 19, s. 545-554
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Tidskriftsartikel (refereegranskat)abstract
- Inner strength is a conceptualization of a human resource that is generally considered beneficial for health and well-being. Previously, it has been examined in qualitative and cross-sectional studies, but longitudinal data are lacking. The aim of this study was to examine how inner strength, health and function, well-being, and negative life events, namely crises and diseases, affect each other over time in old people. A longitudinal two-wave design was used with data from 2010 and 2016. A total of 4023 participants, living in Finland and Sweden, and born in 1930, 1935, 1940, or 1945 were included. Data were collected using the Inner Strength Scale, the Life Orientation Scale, a short version of the Geriatric Depression Scale, one item from the SF36, and five items from the Katz ADL-index. Structural equation modeling was used to test for cross-lagged effects. Crises and diseases were found to be a positive predictor of inner strength, a negative predictor of well-being, and to have no significant effect on health and function over time. Inner strength and well-being had a reciprocal positive relationship, and health and function was a positive predictor inner strength. The study expands findings by providing perspectives of inner strength across time indicating that inner strength in old people increases when they have to face a disease or crisis. From a health perspective, the present findings reinforce the importance of healthcare professionals' awareness and knowledge of the construct of inner strength.
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| 8. |
- Viglund, Kerstin, et al.
(författare)
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Sources and expressions of inner strength among old people who have experienced a crisis in life associated with a disease
- 2017
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 37:1, s. 20-26
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Tidskriftsartikel (refereegranskat)abstract
- Inner strength is reported as an important resource associated with aging, health, and disease management. The aim was toexplore inner strength in people (n ¼ 12) aged 65 years and older, who had experienced a crisis in life associated with a disease. The participants had self-rated their inner strength as high. We found that sources of inner strength were mutual love and support, and the fact that tough times have been managed before. Expressions of inner strength comprised focusing on possibilities instead of brooding, facing and take an active part in care and treatment, and being able to confront reality and pick yourself up again. Inner strength is a complex phenomenon. Increased knowledge of inner strength can serve as an aid inefforts to identify the need to promote inner strength.
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