The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Interviews and Procedures
2.3.1. Research Team
2.3.2. Interviews
2.3.3. Transcripts
2.3.4. Ethical Aspects
2.3.5. Analysis
2.3.6. Rigor
3. Results
3.1. Benefit of Work on Health and Life
3.1.1. Vitality and Happiness
“I find vitality by coming to work, and I have fun while cleaning up for someone and find happiness from it.” (Participant 11)
“Getting paid is great, but working provides vitality and helps me keep healthy, so I like it.” (Participant 1)
“I don’t know about others, but for me coming to work and talking, joking, and laughing with the other women at work is a source of happiness.” (Participant 4)
“It’s good to work. I feel like my health deteriorates if I just sit at home bored because I don’t have any reason to go out.” (Participant 7)
3.1.2. Health Benefits
“In my opinion, if you’re healthy, you will stay healthier if you work. You might be unwell, but once you go to work, you forget about it. I would be sick, but when I go to work, I manage to find the strength to work. Then I forget about feeling sick. It happens like that.” (Participant 10)
3.1.3. Gratitude and Pride
“I always feel so grateful when they extend my contract in January. I promise myself I will work hard for the year. Once the year goes by, I feel the same way in each January and work for another year. That has continued until now. So, I like working.” (Participant 1)
3.1.4. Economic Independence
“Since I make my own money, I do not feel any shame. If not, if I don’t make money and my children give me money, it would be burdensome, and it would not be in line with what I was thinking when I first started working.” (Participant 1)
“Money is important. I’m not saying it is not important, but I put more meaning on being able to move and be active. If I say money is not important, I would be lying. To be honest.” (Participant 4)
3.2. Adaptation to a New Work Environment
3.2.1. New Beginning
“I did not work for a year after I retired. After not working for a year, I thought, if the life expectancy is climbing towards 100, and I am 60, I have another 30 years to live. To live 30 years, I need to earn money. I also need to think about my health. I can have some hobbies as I work in a new environment. It’s like I started a second chapter of my life.” (Participant 2)
3.2.2. Adjusting to Shift Work
“I am used to night shifts. It’s okay for me now. I was able to adjust, but young people these days do not want to take night shifts.” (Participant 12)
“It was difficult at first. But it’s been a while and it became a pattern, so it’s okay now.” (Participant 7)
3.3. Endurance
3.3.1. Reason to Endure Suffering
“I need to do it even if it is hard. I can’t lose this job.” (Participant 12)
“I thought about doing something else. I thought about it, but what would I do? At this age, who will employ me? Just keep doing what I’m doing now, and if it comes to an end, it comes to an end. Where would I go, and what would I do? I can’t.” (Participant 9)
3.3.2. Enduring Physical Symptoms
“I hurt in a lot of different places. I can still manage, and if it gets worse, I go to the doctor’s office. We all endure some pain, right? We don’t always go to the doctor’s office. It’s like that.” (Participant 4)
3.3.3. Persevering through Psychosocial Stress
“Relationships with other people are the most stressful. People are all different, so I just need to be patient and endure.” (Participant 11)
“I slept well when I took half a pill. But once I continued the drug became less effective. […] Even if I sleep for a little bit, I am depending on the medicine. So even if I sleep very lightly, I prefer not to depend on the drug so much. So, I haven’t been sleeping well. It’s been a while since I have.” (Participant 4)
3.4. Continuous Efforts to Maintain Health
3.4.1. Motivations for Self-Management
“Health is life, and life is health. Health is the best. So, best not to be ill. It’s pathetic to lay in bed and be sick when you’re old. So, I think to myself, I need to manage my health.” (Participant 11)
“I should put efforts into maintaining my health and living a healthy life. When I look at my parents, I think to myself, I should not be a burden to my family.” (Participant 5)
“My children inherit my illness. If children have to take care of me, it’s difficult for all of us. If I’m healthy, I’m helping my children.” (Participant 8)
3.4.2. Physical Self-Management
“I need to take medicine every day. I also need to go to the doctor’s office on the appointment day. At the doctor’s office, my blood pressure is measured, and if it is normal, I get 2 months’ worth of medicine. If it is high, I get medicine for 1 month and then go back to check again. At the hospital. I get checked from time to time.” (Participant 4)
“I don’t eat salty food because they say salty food makes you drink a lot of water and increase your blood pressure as a result. Maybe because I don’t eat salty food, my blood pressure is okay these days.” (Participant 8)
“I exercise a lot. First, muscle-strengthening exercises. I do a lot of muscle-strengthening exercises, and I also walk a lot.” (Participant 2)
“Keeping a regular schedule. I take blood pressure medicine in the morning, take omega-3 and other supplements after lunch, and again after dinner. I do this regularly. I never skip and am very precise.” (Participant 11)
3.4.3. Psychological Self-Management
“When that happens, I cope by being happy. There’s no other choice. Only happiness. If I start complaining, I can’t do it. I can’t work if I constantly complain. If someone suggests I do something, I comply and have fun.” (Participant 9)
“I talk with my husband and get advice from him. After coming back from work every day, I look back on my day and think whether I did wrong by anyone I took care of. I reflect on it.” (Participant 10)
“(When I get stressed) I pray and try to relax.” (Participant 5)
3.4.4. Efforts to Obtain Health Information
“Self-management is not really difficult. In order for self-management to be a habit and lifestyle, one must be prepared.” (Participant 8)
“If I don’t do it myself, there’s no other way. I need to do it on my own.” (Participant 10)
“I have a friend who is younger than me, but that friend is forgetful and started taking medicine for prevention dementia. So I started taking the medicine as well.” (Participant 3)
3.5. Difficulties in Self-Management
3.5.1. Time
“The timing also doesn’t work out. Most welfare centers operate in the morning and close by 7 or 8 p.m. Working people like me cannot go even if we want to. […] When I’m done at work and return home, it’s dinner time. Most people eat dinner and go to bed by 7–9 p.m. Most people I ask say they don’t have enough time to exercise. Some have to wake up at 2 am or 4 a.m. So, a lot of people go to bed by 8 p.m. or 9 p.m. They need to go to work at 5 am. So they can’t manage their health.” (Participant 2)
“The timing isn’t right for me. I’m done here at 3:30 p.m., and when I go there, people are already done. It’s around 4:30 p.m. when I get there. Most people leave by 4 p.m. or 5 p.m. I can’t do it because of the timing.” (Participant 4)
3.5.2. Poor Work Environment
“We have to eat food in tiny spaces. Rests are very short. The space is not big enough.” (Participant 3)
“(My workplace is) on the second floor of the basement, and it’s just like a storage space, so the air quality is bad. […] The resting area is very bad. When I enter, I feel my voice change instantly. I also cough. I’d be fine in the morning and start coughing as soon as I go in to work. You know, like foggy pollution.” (Participant 4)
3.5.3. Physical Fatigue after Work
“I can’t be bothered to. Because I work like this during the day, I don’t exercise because I can’t be bothered to.” (Participant 3)
“I can squeeze out time to exercise, but it’s not easy to feel up for it. After work, I feel tired, so I just feel, I don’t want to go today.” (Participant 11)
3.5.4. Social Environment
“Honestly, I feel self-conscious, and I don’t know what other people will think when they see me.” (Participant 1)
“Because I don’t have anyone around me, I find it difficult to go to places to exercise.” (Participant 12)
3.5.5. Cost and Distance
“To do anything, you need money. So, I end up not being able to exercise. […] I have the intention to go, but if it’s far, I can’t go.” (Participant 12)
3.6. Requirements for Health Promotion
3.6.1. Need for Exercise Equipment and Space
“I wish there would be a place senior citizens can go to exercise at any time. A space where we can exercise and meet other people and chat. That would be great.” (Participant 1)
“At least running machines, walking equipment. I would like one of those options.” (Participant 11)
3.6.2. Need for Educational Programs for Self-Management
“If there are places we can go to, such as singing classes…if we can use these services more frequently, we can go for even 30 min or an hour, sing along, and have a fun time. I think that would be good.” (Participant 3)
“When I sometimes look at what’s happening on the first floor, there are programs such as ‘About diabetes.’ I really want to go.” (Participant 1)
3.6.3. Identifying Time for Self-Management through Flexible Work Hours
“If our hours are shorter, there will be some time for self-management. Time for exercise. Even just for an hour, then I will exercise a bit more.” (Participant 3)
“It seems like the programs are only for elderly who stay at home. So, if there are more various times, for example 6 p.m. or 7 p.m., that would be great.” (Participant 1)
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
Main Questions |
---|
What does work mean to elderly workers? |
What does health mean to elderly workers? |
What are the experiences of elderly workers with multiple chronic diseases? |
What are the facilitators of self-management of chronic diseases among elderly workers? |
What are the barriers to self-management of chronic diseases among elderly workers? |
What are the requirements for self-management among elderly workers? |
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ID | Gender | Age | Residence | Education | Occupation | Subjective Socioeconomic Status | Religion | Household Members | Number of Chronic Diseases |
---|---|---|---|---|---|---|---|---|---|
1 | Female | 72 | Daejeon | High school | Sanitation worker | Middle | Catholicism | None | 2 |
2 | Male | 65 | Daejeon | University | Security guard | Middle | Christianity | Spouse | 3 |
3 | Female | 72 | Daejeon | Elementary school | Sanitation worker | Low | Christianity | Unmarried child | 3 |
4 | Female | 67 | Daejeon | Elementary school | Sanitation worker | Low | Buddhism | Spouse | 3 |
5 | Male | 67 | Seoul | High school | Office worker | Middle | Christianity | Spouse | 2 |
6 | Male | 65 | Seoul | Middle school | Business owner | Middle | Christianity | Unmarried child | 3 |
7 | Male | 74 | Seoul | Middle school | Security guard | Middle | Christianity | Unmarried child | 2 |
8 | Male | 73 | Seoul | High school | Security guard | Middle | Christianity | Unmarried child | 2 |
9 | Female | 68 | Seoul | Elementary school | Sanitation worker | Middle | Christianity | Spouse | 4 |
10 | Female | 65 | Seoul | Elementary school | Certified nursing assistant | Middle | Catholicism | Married children | 3 |
11 | Female | 68 | Daejeon | Elementary school | Sanitation worker | Low | Christianity | None | 4 |
12 | Female | 65 | Daejeon | Elementary school | Sanitation worker | Low | Buddhism | None | 3 |
Theme | Sub-Theme |
---|---|
Benefit of work on health and life | ● Vitality and happiness ● Health benefits ● Gratitude and pride ● Economic independence |
Adaptation to a new work environment | ● New beginning ● Adjusting to shift work |
Endurance | ● Reason to endure suffering ● Enduring physical symptoms ● Persevering through psychosocial stress |
Continuous efforts to maintain health | ● Motivations for self-management ● Physical self-management ● Psychological self-management ● Efforts to obtain health information |
Difficulties in self-management | ● Time ● Poor work environment ● Physical fatigue after work ● Social Environment ● Cost and distance |
Requirements for health promotion | ● Need for exercise equipment and space ● Need for educational programs for self-management ● Identifying time for self-management through flexible work hours |
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Kim, J.; Ha, J. The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study. Healthcare 2020, 8, 471. https://doi.org/10.3390/healthcare8040471
Kim J, Ha J. The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study. Healthcare. 2020; 8(4):471. https://doi.org/10.3390/healthcare8040471
Chicago/Turabian StyleKim, Juah, and Jiyeon Ha. 2020. "The Meaning of Work and Self-Management Experiences among Elderly Workers with Multiple Chronic Diseases: A Qualitative Study" Healthcare 8, no. 4: 471. https://doi.org/10.3390/healthcare8040471