THE EFFECTIVENESS AND PERCEIVED EFFECTIVENSS OF SIMPLE REMINISCENCE THERAPY INVOLVING PHOTOGRAPHIC PROMPTS FOR DETERMINING LIFE SATISFACTION IN NONINSTITUTIONALIZED ELDERY PERSONS by Tommie L. Norris, RN, DNS(C) DISSERTATION Presented to the Graduate Faculty in Partial Fulfillment of the Requirements for the Degree of DOCTOR OF NURSING SCIENCE LOUISIANA STATE UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF NURSING New Orleans, Louisiana November, 2001 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. THE EFFECTIVENESS AND PERCEIVED EFFECTIVENESS OF SIMPLE REMINISCNECE THERAPY INVOLVING PHOTOGRAPHIC PROMPTS FOR DETERMINING LIFE SATISFACTION IN NONINSTITUTIONALIZED ELDERLY PERSONS APPROVED BY DISSERTATION COMMITTEE: Jarbara Donlon, RN, Ed.D. atricia Beare, RN, Ph.D. Susanian R. Jacob, RN, Ph.D. / Linn Stranak, DA Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Abstract The purpose of this study was to determine the effectiveness and perceived effectiveness of simple reminiscence therapy using photographic prompts on the life satisfaction of noninstitutionalized elderly persons. The Self-Anchoring-Life Satisfaction Scale (SALSS) was used to measure life satisfaction. Erikson’s Developmental Theory and the concept reminiscence formed the theoretical framework for this study. The convenience sample included 78 men and women, aged 65 years or older, who lived independently in the community. Participants were recruited and randomly assigned to one of three groups using a balanced design and then each group was randomly assigned as either the reminiscence therapy, current events, or no treatment (control group). Five participants did not complete the study. Participants in the reminiscence group met one-to-one with the researcher, for four consecutive weeks to share personal photographs and dialogue about life experiences. They then described their perception of the intervention during a telephone interview following the experience. Those persons in the current events group also met weekly, one-to-one with data collectors, for four consecutive weeks discussing an article from the local newspaper. Participants in both the reminiscence and current events group completed the SALSS and a demographic data form at the first visit, and after four weeks they again completed the SALSS. The control group participants only received pre- and post-testing when beginning the study and again in four weeks. Persons in the current events and control groups did not participate in the telephone interview. Paired t-tests revealed a significant difference in life satisfaction after participating in simple reminiscence therapy. A one-way analysis of variance for gain scores revealed no significant differences between groups; however, a post hoc test, LSD showed the reminiscence and control group approached a significant difference with an alpha of .128. Transcripts from the telephone interviews revealed eleven common themes. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ACKNOWLEDGMENTS Before taking on this monumental endeavor and daily after accepting the challenge of working toward a doctoral degree in nursing, I asked for God’s helping and guiding hand, which was so generously extended time and time again. I also have to thank Dr. Barbara Donlon, who had faith in me from the beginning, even before being admitted to the doctoral program, always encouraging me with a smile and the suggestion to “keep on track”. Dr. Susan Jacob provided the expertise in gerontology and qualitative research along with much needed friendship. Dr. Patricia Beare’s willingness to cheer a weary student while also sharing her knowledge and time was greatly appreciated. Finally Dr. Linn Stranak, who had a kind way of helping me to master statistics, was a valuable asset to this committee. I also want to thank a faculty member, Dr. Jacqueline McNally, who was not a direct member of the dissertation committee. Dr. McNally taught me the meaning of perseverance and that when planning a project, to always double the estimated time required for completion. This proved true with the dissertation process. Mr. Charles Chapman, who provided editorial assistance along with a few “witty” remarks, proved to be an invaluable ally. I also want to thank the directors of Wesley Housing for allowing me to recruit participants for the study. It goes without saying, that I am indebted to the persons who accepted me into their homes and shared their memories. This research was supported in part by a research grant funded by Sigma Theta Tau International Honor Society of Nursing, Beta-Theta-Chapter-At-Large. I am grateful to the research committee for seeing the value of this research. I am most thankful to my family. My mother, Anna Christine Powell, really deserves this degree. She tirelessly rode hundreds of miles while I commuted for my undergraduate and graduate studies, keeping me company and safe on the roads. When I became discouraged, she always replied, “I know you can do it.” Although she won’t be here in person when I accept this degree, I know she is proud. My husband, Stephen Norris, willingly accepted my long days away from home to travel to New Orleans, long hours in front of the computer, and need to ventilate my frustrations. His special hugs kept me going. I also want to thank my four children; i v Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Richie Lee Tidwell, Robby Greg Tidwell, Rachel Lauren Norris, and Stephen Emery Norris, Jr. They often wondered if one ever completes their education. I lost valuable family time and was often preoccupied with thoughts of academic concerns, but they always understood. I also want to thank Raymond and Olivia Norris for their faith in me, their encouragement, and much appreciated financial support. Lastly, I want to thank my parents, Jere and JoAnn Powell for giving me confidence and believing in me throughout my educational endeavors. v Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS CHAPTER Page I. INTRODUCTION......................................................................................................1 Research problem..................................................................................................5 Purpose ..................................................................................................................7 Research Question ................................................................................................7 Research Hypotheses.......................................................................................... 7 Definition of Term s..............................................................................................8 Assumptions ..........................................................................................................9 Limitations ............................................................................................................ 9 Delimitations ....................................................................................................... 10 Significance to Nursing .....................................................................................10 Theoretical Framework ...................................................................................... 11 II. REVIEW OF THE LITERATURE..................................................................... 17 Autobiographical Memory .................................................................................18 Photographs ......................................................................................................... 28 Reminiscence Therapy......................................................................................39 Life Satisfaction ................................................................................................. 62 III. METHOD..............................................................................................................84 Sample.................................................................................................................84 Setting ..................................................................................................................85 Protection of Human Subjects ...........................................................................85 Instruments .......................................................................................................... 85 Demographic Instrument .............................................................................86 Self-Anchoring Life Satisfaction Scale .................................................... 86 Telephone Interview Instrument ................................................................ 88 Procedure.............................................................................................................88 Description of Groups .......................................................................................89 v i Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Intervention 89 Simple Reminiscence Therapy ........................................................ 89 Current Events ...............................................................................................91 Control Group ...............................................................................................91