Mejorar el autocuidado en mujeres de 60 a 80 años mediante el fomento del empoderamiento

Abstract

Objetives The main objective of this thesis was to generate improvements in self-care attitudes towards the ageing process in women aged 60 to 80 by promoting their empowerment. For that, the following specific objectives were described: to analyse, from a gender perspective, the quality of life of older women who participated in a physical exercise programme in Murcia and who responded to the SF-36 questionnaire; to create a group intervention with women between 60 and 80 years of age within the participatory action-research (PAR) approach to promote empowerment and self-care; to analyse conceptually and methodologically the use of participatory action research, as well as its strengths and weaknesses, in the field of empowerment of women aged 60-80; and to understand the process of change in the empowerment and self-care of women aged 60-80 through participatory action research. Methodology A mixed methodology with qualitative and quantitative data was carried out in three scientific articles. On one hand, a secondary analysis was carried out with a gender perspective of a retrospective longitudinal descriptive study of a cohort of women who had participated in the Activa-Murcia Programme, assessing their quality of life using the SF-36 questionnaire. ANOVA and Bonferroni test were used as statistical analysis in 3 age groups and two environments (urban and rural). At the same time, PAR was developed as a research approach, framed in the Socio-Critical Paradigm of Qualitative Methodology, and taking into account two Theories: Feminist Theory and the Self Theory of GESTALT. For this purpose, a group of 10 women between 60 and 80 years old was created in the Health Centre of the Barrio de Carmen, in the city of Murcia. The PAR was developed from June 2019 to May 2020 and consisted of: 22 group sessions; two individual calls to each of the participants to close the group work and several follow-up calls; individual completion of a reflective diary; use of different assessment scales such as Nursing NOC, ASA Self-Care Agency Scale and assessments of functioning at home and personal priorities. A theoretical-methodological analysis of PAR and an interpretative analysis were carried out using Feminist Theory and Self Theory of GESTALT as theoretical references. Conclusions The dimensions most affected by ageing in older women and which did not improve with this intervention were those most related to the psychological sphere and personal agency: mental health, emotional role and vitality. Women's quality of life worsens as the years go by and this has repercussions on empowerment strategies, affecting self-care. In relation to the field work carried out with the women through group intervention, applying the PAR approach, the creation of the group was the first result in terms of improving their empowerment to promote self-care, as networks of joint work were established which acted as elements of support, generating the necessary confidence to move along the path of change. The use of PAR to promote empowerment and self-care in older women was a facilitating tool for change. This type of approach seeks transformation and emancipation, and it is an empowering tool. It is key to initiate group work in a simple way, to use social skills strategies, to ensure confidentiality as the basis of the group and to maintain group cohesion through follow-up calls during periods of inactivity. At the same time, the high volume of data generated in this type of research must be taken into account in the initial approach. It is important to work on joint and individual reflection with the older women, who are not used to listening to and visualising themselves. The transformation in this group of older women took place following two specific patterns of change (women leaders and women followers) who made changes in two different but interrelated worlds (inner world and outer world) in relation to three key characteristics of empowerment and self-care: self-determination, self-esteem and self-confidence.