Abstract:

The purpose of this research was to develop and evaluate a group intervention for reducing the disability associated with aging, thereby increasing quality of life. The intervention was composed of a six-week, group format workshop. The workshop was a refinement and modification of an empirically validated program developed by the Rural Institute on Disabilities to reduce the disability associated with spinal cord injury. This program was founded in the integration of behavioral practices and the confluence of two cognitive theories; the Sense of Coherence theory and the Explanatory Style theory. Components of the intervention included goal setting, problem solving, modification of explanatory style, depression management, communication training, health information and change maintenance techniques. Participants volunteered to be in one of two groups, (1) the workshop group, (2) a comparison group who only received a mail-out survey. It was hypothesized that participants in the intervention group would improve significantly more than the other group on measures of (1) disability and health status, (2) depression, (3) quality of life, and (4) decreased utilization of health services. This hypothesis received mixed support. Although initial analyses revealed no statistically significant effects on disability, depression, quality of life or utilization of health services, there were mean trends in the predicted direction on level of disability and depression. Based on the finding in the original application of the Living Well intervention with people with physical disabilities, attempts were made to control for pre-test levels of depression. Analyses on a non-depressed subsample revealed statistically significant effects of the intervention on level of disability, or health status (both physical health and mental health). These results suggest that the Living Well intervention does significantly improve the health status of those individuals who are less depressed when they enter into the program. The implication of this finding on future research is discussed.