Volume 33, Issue 123 (April 2020)                   IJN 2020, 33(123): 6-21 | Back to browse issues page

XML Persian Abstract Print

Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Lalehkani M, Davati A, Isanejad A, Jadid-Milani M. The Correlation between Happiness and Self-transcendence in the Elderly of Khoshkrud, Zarandieh City. IJN 2020; 33 (123) :6-21
URL: http://ijn.iums.ac.ir/article-1-3157-en.html
1- Department of Nursing, Shahed University, Tehran, Iran
2- Department of Medicine, Shahed University, Tehran, Iran
3- Department of Physical Education, Shahed University, Tehran, Iran
4- Department of Nursing, Shahed University, Tehran, Iran. (Corresponding Author) Tel: 02151212143 Email: milani@shahed.ac.ir
Abstract:   (3467 Views)
Background & Aims: The population of the elderly has been on a rise, which shows more attention to ensuring the health and well-being of the elderly. On the other hand, the growth of the elderly population and its impact on the social and economic conditions of society leads to more attention to the issue of aging in society. In addition, physical and psychological abilities decrease with aging, which affects the quality of life of people. Overall, quality of life and well-being assessed by indicators such as health, happiness, and loneliness. Happiness is one of the most important needs of human beings, which considerably affects their psychological and physical health that helping the elderly cope with stressful situations. Another factor affecting well-being is self-transcendence, which is a powerful coping mechanism and can lead to personal transformation and improvement of the quality of life, thereby facilitating the process of understanding life changes such as aging. Therefore, self-transcendence is defined as a positive trait in relation to the expansion of one’s outlook on life. This issue includes factors such as spirituality, finding a purpose in life, optimism for the future, coping with problems, using power-based approaches, and connecting with others. In the elderly, by restoring the concept of aging and accepting disability, it reduces stress and focuses more on ability than disability. Therefore, happiness and self-transcendence are important factors in the elderly’s health dimensions. The present study aimed to determine the relationship between happiness and self-transcendence in the elderly of Khoshkrud, Zarandieh City.
Materials & Methods: This descriptive-correlational research performed on the elderly selected from those who referred to the health center to receive elderly-related care using sequential sampling. Data collection continued for three months (October-December, 2019), and 84 elderlies who were willing to participate in the research were selected. The inclusion criteria were the age of more than 60 years, the ability to respond to questions physically and mentally, having psychological health  which assessed  by Abbreviated Mental Test (obtaining a score above 7) and not losing a family member or experiencing a stressful situation in the past two months. Abbreviated Mental Test used to diagnose cognitive impairment, including dementia and delirium in the elderly, applied to assess concentration, attention, short-term and long-term memory. Notably, the Cronbach’s alpha of the tool was 0.76 in Iranian society. The Oxford Happiness Index has 29 questions that scored in a range of zero to 87 and includes five components of life satisfaction, self-honor, subjective well-being, satisfaction, and positive mood. Internal consistency was used to determine the reliability of the instrument. The Cronbach's alpha coefficient for the components of life satisfaction, self-honor, subjective well-being, satisfaction, and positive mood estimated at 0.85, 0.71, 0.74, 0.79, and 0.77, respectively. On the other hand, the self-transcendence questionnaire included 15 items scored in a range of 15-60, where a higher score was indicative of higher self-transcendence. Internal consistency was used to determine the reliability of the instrument and its Cronbach's alpha coefficient estimated to be 0.69. Researcher with questions from the elderly completed all tools and it took an average of 45 minutes for each elderly person to complete the tools. In addition, data analysis was performed in SPSS version 16 using descriptive statistics (to describe demographic variables and variables of happiness and self-transcendence) and parametric inferential statistics (Pearson’s correlation coefficient, independent t-test, and analysis of variance).
Results: In this study, the mean age of the elderly was 65.7±4.8 (60, 79). Moreover, 55 subjects were female (65.5%), 81% were married, 59.5% were illiterate and 64.3% were homemakers. In addition, the mean number of children of the participants was 6.2±1.6 (0, 14). Furthermore, 66.7% had an underlying illness, 56% had a moderate economic status, 61.9% had a family support system and 79.8% lived with their spouse. According to the results, the mean of happiness and self-transcendence in the elderly were 54.42±14.3 and 39.4±5.9, respectively. There was a significant and direct relationship between self-transcendence and happiness (r=0.263, P=0.016), components of life satisfaction (r=0.348, P=0.001) and satisfaction (r=0.325, P=0.003). In addition, a significant difference was observed between the level of education (P=0.038 and P=0.009, respectively) with happiness and self-transcendence and between occupational status and happiness (P=0.039). Moreover, a significant difference was found between the number of children (P=0.037) and residential status (P=0.028) with self-transcendence.
Conclusion: According to the results of the study, happiness and its components were more than the average level in the elderlies. In addition, the results were indicative that level of education, job, and economic status had significant differences with happiness. A proper education, job and economic status creates safety in the individual, which improves happiness. Self-transcendence was moderate and economic status, level of education, residential status and number of children had significant differences with elderly’s self-transcendence. Good economic situation causes security in the person and the person can try to help himself without worry and play a role in promoting self-transcendence. On the other hand, the level of education promotes awareness and the ability to obtain information from various sources, which can empower the elderly in self-care and increase their adaptation to old age, and ultimately lead to the promotion of self-transcendence. The presence of children, their support, and care for parents cause security for the elderly, who in return try to adapt to the current situation in order to calm their children and accept their situation and ultimately improve their self-transcendence. In general, self-transcendence promoted by having a good friend and a person to talk to, and in the traditional society of Khoshkroud, communication with children, relatives, and neighbors can promote self-transcendence. Although in the present study, the economic situation was moderate and most of the elderly were illiterate, the level of happiness and self-transcendence of the participants was above average, which can be attributed to the existence of social relations at the family and traditional society and respect for the elderly. These factors played a key role in individual satisfaction and support of the elderly and covered the educational and economic states. Moreover, there was a direct and significant relationship between happiness and self-transcendence. Happy people feel more in control, think more about their abilities rather than inabilities, better cope with life stressors, have higher self-esteem, value themselves, and love themselves. Overall, happiness can affect the scope of life and the way people relate and interact with the environment. As such, happiness promotes other life aspects, including self-transcendence. In Khoshkroud, where the elderly and families adhere to their religious and traditional beliefs and the family has a special position, the elderly enjoy health in all dimensions, and they can accept the conditions of old age and use effective adaptation mechanisms to improve well-being. It recommend that the families and authorities by meeting the economic, social and spiritual needs of the elderly to increase their ability to understand and accept themselves, create a sense of satisfaction and happiness, which increases their health. By creating a happy and lively environment, their performance will be improve, which has positive consequences for the elderly, family, and society. Furthermore, conditions should be provided for them to benefit from each other's experiences and to be present in public to improve their health.
Full-Text [PDF 1093 kb]   (1265 Downloads)    
Type of Study: Research | Subject: nursing
Received: 2020/01/6 | Accepted: 2020/04/6 | Published: 2020/04/6

1. Statistical Center of Iran. Available from: www.sarshomari 95.ir. Accessed December 25,2019.
2. Masoumi N, Masoumi B, Shoujaei F, Sharafi SF. A review of postural balance and its related factors in the elderly. Crescent Journal of Medical and Biological Sciences. 2015; 2(1): 28-31.
3. Marsillas S, De Donder L, Kardol T, van Regenmortel S, Dury S, Brosens D, Smetcoren AS, Brana T, Varela J. Does active ageing contribute to life satisfaction for older people? Testing a new model of active ageing. Euro J Ageing. 2017;14(3):295-310. [DOI:10.1007/s10433-017-0413-8] [PMID] [PMCID]
4. Arman M. The comparison of depression, anxiety and stress between active and inactive old women in Isfahan. Rehabilitation Medicine. 2014;3(3): 82-8.
5. Moreno Minguez A, Vicente Vírseda JA. Well-being and living arrangement of elderly people from European comparative perspective. Soc Sci J. 2019;56(2):228-42. [DOI:10.1016/j.soscij.2018.11.007]
6. Vitale SA, Shaffer CM, Acosta Fenton HR. Self-transcendence in alzheimer's disease: The application of theory to practice. Journal of Holistic Nursing. 2014;32(4):347-55. [DOI:10.1177/0898010114531857] [PMID]
7. Limpuangthip N, Somkotra T, Arksornnukit M. Impacts of Denture Retention and Stability on Oral Health-Related Quality of Life, General Health, and Happiness in Elderly Thais. Current gerontology and geriatrics research. 2019 Jul 16; 3830267. [DOI:10.1155/2019/3830267] [PMID] [PMCID]
8. Duba T. Socioeconomic determinants of happiness of the elderly in Bhutan. Unpuplished master Thesis. Chulalongkorn University, Bhutan. 2017. Available from: http://cuir.car.chula.ac.th/handle/123456789/61244. Accessed june 9, 2020.
9. Nanthamongkolchai S, Nanthamongkolchai S, Tuntichaivanit C, Munsawaengsub C, Munsawaengsub C, Charupoonphol P, Charupoonphol P. Factors influencing life happiness among elderly female in Rayong Province, Thailand. J Med Assoc Thai. 2009; 92 (7): S8-S12.
10. Jeon SW, Han C, Lee J, Lim J, Jeong HG, Park MH, Ko YH, Pae CU, Kim SH, Joe SH, Steffens DC. Perspectives on the happiness of community-dwelling elderly in Korea. Psychiatry investigation. 2016;13(1):50-7. [DOI:10.4306/pi.2016.13.1.50] [PMID] [PMCID]
11. Aliakbari Dehkordi M, Peymanfar E, Mohtashami T, Borjali A. The comparison of different levels of religious attitude on sense of meaning, loneliness and happiness in life of elderly persons under cover of social wlfare organisation of Urmia city. Iranian Journal of Ageing. 2015;9(4):297-305.
12. Ahmadi A, Soleimani MA, Pahlevan Sharif S, Motalebi SA. Association between Perceived Social Support and Happiness among Community-dwelling Elderly Adult. The Journal of Qazvin University of Medical Sciences. 2019;23(4):320-31. [DOI:10.32598/JQUMS.23.4.320]
13. Moeini B, Barati M, Farhadian M, Ara MH. The association between social support and happiness among elderly in Iran. Korean journal of family medicine. 2018;39(4):260. [DOI:10.4082/kjfm.17.0121] [PMID] [PMCID]
14. Yousefi Z, Sharifi K, Tagharrobi Z, Akbari H. The effect of narrative reminiscence on happiness of elderly women. Iranian Red Crescent Medical Journal. 2015;17(11):e19612. [DOI:10.5812/ircmj.19612]
15. Kahrazei F, Akbarizadeh A. Comparison of the general health and happiness of the elderly living in nursing homes, private homes with and without family-based rehabilitation Services. Journal of Gerontology. 2020;4(3):56-67. [DOI:10.29252/joge.4.3.56]
16. Ghadampour E, Karami A, Khodarahimi S. The Comparison of Spiritual Well-Being, Tolerance of Ambiguity and Happiness in the Elderly Living in the Home and the Nursing Home. Medical Ethics Journal. 2019;13(44):1-3.
17. Abdkhodaei MS. Effects of cognitive-behavioral Fordyce happiness training on sense of coherence in patients with type 2 diabetes. J Neyshabur Univ Med Sci. 2017;4(4):1-10.
18. Liu YH, Liu JC, Lin MT, Chen WC. Participation of senior citizens in somatosensory games: a correlation between the willingness to exercise and happiness. J Ambient Intell Human Comp. 2020 Apr 13. [DOI:10.1007/s12652-020-01918-y]
19. Tenney ER, Poole JM, Diener E. Does positivity enhance work performance?: Why, when, and what we don't know. Research in Organizational Behavior. 2016;36:27-46. [DOI:10.1016/j.riob.2016.11.002]
20. Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman ME, Labarthe DR. Reprint of: Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series. J Am College Cardiol. 2018;72:3012-26. https://doi.org/10.1016/j.jacc.2018.07.042 [DOI:10.1016/j.jacc.2018.10.023] [PMID] [PMCID]
21. Massey CN, Feig EH, Duque-Serrano L, Wexler D, Moskowitz JT, Huffman JC. Well-being interventions for individuals with diabetes: A systematic review. Diabetes Res Clin Pract. 2019;147:118-33. [DOI:10.1016/j.diabres.2018.11.014] [PMID] [PMCID]
22. Avasthi A, Grover S. Clinical practice guidelines for management of depression in elderly. Indian journal of psychiatry. 2018;60(Suppl 3):S341-S62.
23. Fakhar F, Navayinezhad S, Foroughan M. The role of group counseling with logo-therapeutic approach on the mental health of older women. Iranian journal of ageing. 2008;3(1):58-67.
24. Heintzelman SJ, Diener E. Subjective well-being, social interpretation, and relationship thriving. J Res Person. 2019;78:93-105. [DOI:10.1016/j.jrp.2018.11.007]
25. Dumitrescu AL, Kawamura M, Dogaru BC, Dogaru CD. Relation of achievement motives, satisfaction with life, happiness and oral health in Romanian university students. Oral health & preventive dentistry. 2010;8(1): 15-22.
26. Bahrami F, Ramazani A. The role of internal and external religious believes on psychological health and rate of depression of elderly. Quarterly J Rehabilitation. 2005; 6 (20): 86-92.
27. Fiske E. Self-Transcendence Theory and Contemplative Practices. Holistic nursing practice. 2019;33(5):266-72. [DOI:10.1097/HNP.0000000000000340] [PMID]
28. Haugan G, Rannestad T, Garåsen H, Hammervold R, Espnes GA. The self-transcendence scale: an investigation of the factor structure among nursing home patients. Journal of Holistic Nursing. 2012;30(3):147-59. [DOI:10.1177/0898010111429849] [PMID]
29. Jadid Milani M , Malek Khahi A , Jafarzadeh M , Rakhshani M.. The effect of peer support groups on physical health status in patients treated with hemodialysis. Journal of Sabzevar University of Medical Sciences. 2015; 21(6): 993-1000.
30. Hoshi M. Self-transcendence, vulnerability, and well-being in hospitalized Japanese elders. Unpuplished PhD Thesis. The Univrsity of Arizona, USA. 2008.
31. Jadid Milani M, Ashktorab T, Abed Saeedi ZH, Alavi Majd H. The relationship between self-transcendence and perceived physical health in patients with multiple sclerosis (MS) attending peer support groups. Journal of Research in Behavioural Sciences. 2012;9(5):105-14.
32. Norberg C. Understanding spirituality and religiosity among very old people: measurements and experiences (Doctoral dissertation, Department of Nursing, Umeå University). 2020
33. Thomas NF, Dunn KS. Self-Transcendence and Medication Adherence in Older Adults With Hypertension. J Holist Nurs. 2014;32(4):316-26. [DOI:10.1177/0898010114528379] [PMID]
34. Upchurch S. Self-transcendence and activities of daily living: The woman with the pink slippers. J Holist Nurs. 1999;17(3):251-66. [DOI:10.1177/089801019901700303] [PMID]
35. Sabaghi Qomi T. Comparison of general health and self-transcendence in active and inactive elderly women in Qom, Iran. Unpuplished master Thesis. Shahid Beheshti Medical Science University, Tehran. Iran. 2017.
36. Nygren B, Aléx L, Jonsén E, Gustafson Y, Norberg A, Lundman B. Resilience, sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging Ment Health. 2005;9(4):354-62. [DOI:10.1080/1360500114415] [PMID]
37. Kim SS, Hayward RD, Reed PG. Self-transcendence, spiritual perspective, and sense of purpose in family caregiving relationships: a mediated model of depression symptoms in Korean older adults. Aging Ment Health. 2014;18(7):905-13. [DOI:10.1080/13607863.2014.899968] [PMID]
38. Haugan G, Innstrand ST. The effect of self-transcendence on depression in cognitively intact nursing home patients. ISRN psychiatry. 2012;2012. [DOI:10.5402/2012/301325] [PMID] [PMCID]
39. Kim SY, Lee JI. Self-transcendence, spiritual well-being, and death anxiety of the elderly. Journal of Korean Public Health Nursing. 2013;27(3):480-9. [DOI:10.5932/JKPHN.2013.27.3.480]
40. Reed PG. Theory of self-transcendence. Middle range theory for nursing. 2008 , 3th ed. New York, NY: Springer.2020.
41. Kwok JY, Kwan JC, Auyeung M, Mok VC, Chan HY. The effects of yoga versus stretching and resistance training exercises on psychological distress for people with mild-to-moderate Parkinson's disease: Study protocol for a randomized controlled trial. Trials. 2017;18(1):509-22. [DOI:10.1186/s13063-017-2223-x] [PMID] [PMCID]
42. Khoshkrood city Municipality. Available from: http://khoshkroodcity.ir/. Accessed June 25, 2020.
43. Foroughan M, Hossieni M, Rashedi V, Rezaie M. Comparison of cognitive function in the monolingual and bilingual. J Kermanshah Univ Med Sci. 2015; 18(10): 607-9.
44. Hajaty S, Bastani F. Mental Health and its Correlates in the Elderly with Fall Related Orthopedic Surgery. Iranian Journal of Nursing Research. 2019;14(5):5-13.
45. Farokhnezhad Afshar P, Bastani F, Haghani H, Valipour O. Hospital Anxiety and Depression in the Elderly with Chronic Heart Failure. Iran Journal of Nursing. 2019;32(120):80-9.
46. Francis LJ, Brown LB, Lester D, Philipchalk R. Happiness as stable extraversion: A cross-cultural examination of the reliability and validity of the Oxford Happiness Inventory among students in the UK, USA, Australia, and Canada. Personality and Individual Differences. 1998;24(2):167-71. [DOI:10.1016/S0191-8869(97)00170-0]
47. Lu L, Argyle M. Happiness and cooperation. Personality and individual differences. 1991;12(10):1019-30. [DOI:10.1016/0191-8869(91)90032-7]
48. Alipour A, Agah Heris M. Reliability and validity of the Oxford Happiness Inventory among Iranians. Journal of Iranian psychologists. 2007;3(12):287-98.
49. Alipoor A, Noorbala AA. A preliminary evaluation of the validity and reliability of the Oxford happiness questionnaire in students in the universities of Tehran. Iranian Journal of Psychiatry and Clinical Psychology. 1999;5(1):55-66.
50. Poordad S, Momeni K, Karami J. The Mediation Role of Social Support and Happiness on The Relationship between Gratitude and Death Anxiety in The Elderly. Journal of Psychological Studies. 2019; 15(1): 57-79.
51. Jadid-Milani M. Reed's Self-transcendence Theory Test: Effect of Peer Groups on Improving the Physical Health Status of Patients with Multiple Sclerosis. Unpuplished Ph.D. Thesis. Shahid Beheshti Medical Science University, Tehran. Iran. 2010.
52. Haugan G, Rannestad T, Garåsen H, Hammervold R, Espnes GA. The self-transcendence scale: an investigation of the factor structure among nursing home patients. J Holist Nurs. 2012;30(3):147-59. [DOI:10.1177/0898010111429849] [PMID]
53. Shirbeigi M, Esmaili Z, Sarmadi MR, Moradi A. Study and comparing 3 groups of active, passive, and ecotourist old age people on their mental health and happiness living in Illam City, Iran. Iranian Journal of Ageing. 2016;10(4):40-9.
54. Almasi M, Mahmoudiani S, Jafari M. Factors associated with feelings of happiness among the elderly. Iran Journal of Nursing. 2015;27(92):23-32. [DOI:10.29252/ijn.27.92.23]
55. Tamimipour H. A Study on the Relationship Between Happiness and Perfectionism in Male and Female Students of the Institute of Higher Education, Jahad University of Khuzestan. Journal of Advanced Progress in Behavioral Sciences. 2017;2(11):78-84.

Add your comments about this article : Your username or Email:

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2015 All Rights Reserved | Iran Journal of Nursing

Designed & Developed by : Yektaweb