International Journal of

ADVANCED AND APPLIED SCIENCES

EISSN: 2313-3724, Print ISSN: 2313-626X

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 Volume 10, Issue 4 (April 2023), Pages: 176-187

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 Original Research Paper

A qualitative cross-case analysis of older adults’ acceptance and resiliency behaviors amidst the COVID-19 pandemic crisis

 Author(s): 

 Evelyn E. Feliciano 1, 2, *, Alfredo Z. Feliciano 2, 3, Wedad A. Alanazi 4, Zenaida S. Fernandez 2, Karen D. Sembrano 2, Joan Russel D. Feliciano 2, Ma. Teresa T. Cabanayan 2, Brenda B. Policarpio 2, Jerry P. Ligawen 2

 Affiliation(s):

 1Eldon Nursing and Rehabilitation, Missouri, 65026, USA
 2College of Nursing and Graduate Studies, Angeles University Foundation, Angeles, 2009, Philippines
 3Encompass Health Rehabilitation Hospital, Arizona, 85206, USA
 4Department of Nursing, College of Applied Medical Sciences, Majmaah University, Al Majmaah, 11952, Saudi Arabia

  Full Text - PDF          XML

 * Corresponding Author. 

  Corresponding author's ORCID profile: https://orcid.org/0000-0001-9120-1534

 Digital Object Identifier: 

 https://doi.org/10.21833/ijaas.2023.04.022

 Abstract:

Resilience has been identified as a dynamic process of sustaining healthy acceptance, adaptation, and effective coping strategies – multiplicity within the aging population is broadly acknowledged. Recognize the concept of resiliency with acceptance in aging interposes during successful aging. Seven 65-75-year-old adult purposive samples were interviewed, and data were collected, extracted, analyzed, and validated with four neutral major themes and 12 supporting subthemes using Colaizzi's method. The study was designed to validate a proposition in the aging-related resiliency theory, which states that when risks and adversities of aging are accepted, older adults tend to use adaptive strategies and supportive resources to improve their coping and resilience. Seven older adults (65-75 years old) purposive samples were interviewed, and data were collected, extracted, analyzed, and validated with four neutral major themes and 12 supporting subthemes using Colaizzi's method. During the COVID-19 pandemic, it is essential to include healthcare interventions that may augment acceptance and resilience in a manner of promoting older adults' healthy aging. It is also important to provide guidelines on how to reduce the negative effects on older adults during the pandemic.

 © 2023 The Authors. Published by IASE.

 This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

 Keywords: Adaptation, Acceptance, Coping, Resilience, Stress, Successful aging

 Article History: Received 25 August 2022, Received in revised form 1 January 2023, Accepted 30 January 2023

 Acknowledgment 

All authors would like to thank the older adult residents of Pampanga, who voluntarily and enthusiastically participated in this academic work.

 Funding

The authors would like to thank the Deanship of Scientific Research at Majmaah University, Kingdom of Saudi Arabia under Project No. R-2022-333 for supporting this work.

 Compliance with ethical standards

 Ethical consideration

Since the interview is in an informal “personal touch” conversational form, the researchers provided participants with informed consent after explaining the nature and its study purpose. The participation was made voluntarily agreed within the participants. All who agreed to participate were asked to sign the said letter of consent as approved by the Institutional Review Board and likewise retained a copy for themselves.

 Informed consent

Informed consent was secured from the respondents of the study. The informed consent detailed the subject status, purpose, type of data, nature of commitment, subject selection, procedures, and potential risks and benefits. Moreover, an emphasis on subject confidentiality was maintained throughout the course of the study.

 Conflict of interest: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

 Citation:

 Feliciano EE, Feliciano AZ, Alanazi WA, Fernandez ZS, Sembrano KD, Feliciano JRD, Cabanayan MTT, Policarpio BB, and Ligawen JP (2023). A qualitative cross-case analysis of older adults’ acceptance and resiliency behaviors amidst the COVID-19 pandemic crisis. International Journal of Advanced and Applied Sciences, 10(4): 176-187

 Permanent Link to this page

 Figures

 Fig. 1

 Tables

 Table 1 Table 2 Table 3

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 References (69)

  1. Aburn G, Gott M, and Hoare K (2016). What is resilience? An integrative review of the empirical literature. Journal of Advanced Nursing, 72(5): 980-1000. https://doi.org/10.1111/jan.12888   [Google Scholar] PMid:26748456
  2. Allen RS, Haley PP, Harris GM, Fowler SN, and Pruthi R (2011). Resilience: Definitions, ambiguities, and applications. In: Resnick B, Gwyther L, and Roberto K (Eds.), Resilience in aging: 1-13. Springer, New York, USA. https://doi.org/10.1007/978-1-4419-0232-0_1   [Google Scholar]
  3. Amankwaa I, Nelson K, Rook H, and Hales C (2022). Association between body mass index, multi-morbidity and activities of daily living among New Zealand nursing home older adults: A retrospective analysis of nationwide InterRAI data. BMC Geriatrics, 22: 62. https://doi.org/10.1186/s12877-021-02696-8   [Google Scholar] PMid:35042475 PMCid:PMC8767739
  4. Amieva H, Avila-Funes JA, Caillot-Ranjeva S, Dartigues JF, Koleck M, Letenneur L, and Bergua V (2021). Older people facing the crisis of COVID-19: Between fragility and resilience. The Journal of Frailty and Aging, 10(2): 184-186. https://doi.org/10.14283/jfa.2020.60   [Google Scholar] PMid:33575710 PMCid:PMC7680077
  5. Andersen SL, Sweigart B, Sebastiani P, Drury J, Sidlowski S, and Perls TT (2019). Reduced prevalence and incidence of cognitive impairment among centenarian offspring. The Journals of Gerontology: Series A, 74(1): 108-113. https://doi.org/10.1093/gerona/gly141   [Google Scholar] PMid:29931286 PMCid:PMC6298187
  6. Angevaare MJ, Monnier AA, Joling KJ, Smalbrugge M, Schellevis FG, Hertogh CMPM, and Huisman M (2020). The application of the concept of resilience in aging research and older adult care: A focus group study. Frontiers in Medicine, 7: 365. https://doi.org/10.3389/fmed.2020.00365   [Google Scholar] PMid:32850888 PMCid:PMC7417312
  7. Annele U, Satu KJ, and Timo ES (2019). Definitions of successful ageing: A brief review of a multidimensional concept. Acta Bio Medica: Atenei Parmensis, 90(2): 359. https://doi.org/10.23750/abm.v90i2.8376   [Google Scholar] PMid:31125022 PMCid:PMC6776218
  8. Araújo L, Ribeiro O, Teixeira L, and Paúl C (2016). Successful aging at 100 years: The relevance of subjectivity and psychological resources. International Psychogeriatrics, 28(2): 179-188. https://doi.org/10.1017/S1041610215001167   [Google Scholar] PMid:26205318
  9. Armitage R and Nellums LB (2020). COVID-19 and the consequences of isolating the elderly. The Lancet Public Health, 5(5): e256. https://doi.org/10.1016/S2468-2667(20)30061-X   [Google Scholar] PMid:32199471
  10. Aruta JJBR (2022). Socio-ecological determinants of distress in Filipino adults during COVID-19 crisis. Current Psychology, 41(11): 7482-7492. https://doi.org/10.1007/s12144-020-01322-x   [Google Scholar] PMid:33424204 PMCid:PMC7783297
  11. Banerjee D (2020). ‘Age and ageism in COVID-19’: Elderly mental health-care vulnerabilities and needs. Asian Journal of Psychiatry, 51: 102154. https://doi.org/10.1016/j.ajp.2020.102154   [Google Scholar] PMid:32403024 PMCid:PMC7198430
  12. Boltz M, Kuzmik A, Resnick B, Trotta R, Mogle J, BeLue R, and Galvin JE (2018). Reducing disability via a family centered intervention for acutely ill persons with Alzheimer’s disease and related dementias: Protocol of a cluster-randomized controlled trial (Fam-FFC study). Trials, 19: 496. https://doi.org/10.1186/s13063-018-2875-1   [Google Scholar] PMid:30223870 PMCid:PMC6142366
  13. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, and Rubin GJ (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. The Lancet, 395(10227): 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8   [Google Scholar] PMid:32112714
  14. Buenaventura RD, Ho JB, and Lapid MI (2020). COVID-19 and mental health of older adults in the Philippines: A perspective from a developing country. International Psychogeriatrics, 32(10): 1129-1133. https://doi.org/10.1017/S1041610220000757   [Google Scholar] PMid:32349826 PMCid:PMC7235307
  15. Carandang RR, Shibanuma A, Asis E, Chavez DC, Tuliao MT, and Jimba M (2020). “Are Filipinos aging well?”: Determinants of subjective well-being among senior citizens of the community-based ENGAGE study. International Journal of Environmental Research and Public Health, 17(20): 7636. https://doi.org/10.3390/ijerph17207636   [Google Scholar] PMid:33092078 PMCid:PMC7588882
  16. Cederbom S, Leveille SG, and Bergland A (2019). Effects of a behavioral medicine intervention on pain, health, and behavior among community-dwelling older adults: A randomized controlled trial. Clinical Interventions in Aging, 14: 1207-1220. https://doi.org/10.2147/CIA.S208102   [Google Scholar] PMid:31308644 PMCid:PMC6615714
  17. Chaves CF, Mazzotti DR, Cendoroglo MS, Ramos LR, Tufik S, Silva VCD, and D'Almeida V (2018). Genes related to maintenance of autophagy and successful aging. Arquivos de Neuro-Psiquiatria, 76: 831-839. https://doi.org/10.1590/0004-282x20180142   [Google Scholar] PMid:30698207
  18. Colaizzi P (1978). Psychological research as a phenomenologist views it. In: Valle RS and King M (Eds.), Existential phenomenological alternatives for psychology. Open University Press, New York, USA.   [Google Scholar]
  19. Cosco TD, Kok A, Wister A, and Howse K (2019). Conceptualising and operationalising resilience in older adults. Health Psychology and Behavioral Medicine, 7(1): 90-104. https://doi.org/10.1080/21642850.2019.1593845   [Google Scholar] PMid:34040841 PMCid:PMC8114384
  20. Evans D (2022). Making sense of evidence-based practice for nursing: An introduction to quantitative and qualitative research and systematic reviews. Routledge, Oxfordshire, UK. https://doi.org/10.4324/9781003156017   [Google Scholar]
  21. Fardin MA (2020). COVID-19 epidemic and spirituality: A review of the benefits of religion in times of crisis. Jundishapur Journal of Chronic Disease Care, 9(2): e104260. https://doi.org/10.5812/jjcdc.104260   [Google Scholar]
  22. Feliciano E, Feliciano A, Palompon D, and Boshra A (2022). Aging-related resiliency theory development. Belitung Nursing Journal, 8(1): 4-10. https://doi.org/10.33546/bnj.1631   [Google Scholar]
  23. Fielding RA, Guralnik JM, King AC, Pahor M, McDermott MM, Tudor-Locke C, and LIFE Study Group (2017). Dose of physical activity, physical functioning and disability risk in mobility-limited older adults: Results from the LIFE study randomized trial. PLOS ONE, 12(8): e0182155. https://doi.org/10.1371/journal.pone.0182155   [Google Scholar] PMid:28820909 PMCid:PMC5562326
  24. Fredriksen-Goldsen KI, Kim HJ, Shiu C, Goldsen J, and Emlet CA (2015). Successful aging among LGBT older adults: Physical and mental health-related quality of life by age group. The Gerontologist, 55(1): 154-168. https://doi.org/10.1093/geront/gnu081   [Google Scholar] PMid:25213483 PMCid:PMC4542897
  25. Galica J, Liu Z, Kain D, Merchant S, Booth C, Koven R, and Haase KR (2021). Coping during COVID-19: A mixed methods study of older cancer survivors. Supportive Care in Cancer, 29(6): 3389-3398. https://doi.org/10.1007/s00520-020-05929-5   [Google Scholar] PMid:33404813 PMCid:PMC7786158
  26. Guetterman TC (2020). Qualitative, quantitative, and mixed methods research sampling strategies. Oxford University Press, Oxford, UK. https://doi.org/10.1093/obo/9780199756810-0241   [Google Scholar]
  27. Hadley EC, Kuchel GA, and Newman AB (2017). Report: NIA workshop on measures of physiologic resiliencies in human aging. The Journals of Gerontology: Series A, 72(7): 980-990. https://doi.org/10.1093/gerona/glx015   [Google Scholar] PMid:28475732 PMCid:PMC5861884
  28. Hagedoorn EI, Paans W, Jaarsma T, Keers JC, van der Schans C, and Luttik ML (2017). Aspects of family caregiving as addressed in planned discussions between nurses, patients with chronic diseases and family caregivers: A qualitative content analysis. BMC Nursing, 16: 37. https://doi.org/10.1186/s12912-017-0231-5   [Google Scholar] PMid:28701898 PMCid:PMC5504762
  29. Hicks G and Miller RR (2011). Physiological resilience. In: Resnick B, Gwyther L, and Roberto K (Eds.), Resilience in aging: 89-103. Springer, New York, USA. https://doi.org/10.1007/978-1-4419-0232-0_6   [Google Scholar]
  30. Hochhalter AK, Smith ML, Ory MG (2011). Successful aging and resilience: Applications for public health and health care. In: Resnick B, Gwyther L, and Roberto K (Eds.) Resilience in aging: 15-29. Springer, New York, USA. https://doi.org/10.1007/978-1-4419-0232-0_2   [Google Scholar]
  31. Huisman M, Klokgieters SS, and Beekman ATF (2017). Successful ageing, depression and resilience research: A call for a priori approaches to investigations of resilience. Epidemiology and Psychiatric Sciences, 26(6): 574-578. https://doi.org/10.1017/S2045796017000348   [Google Scholar] PMid:28689499 PMCid:PMC6999036
  32. Jeste DV, Glorioso D, Lee EE, Daly R, Graham S, Liu J, and Kim HC (2019). Study of independent living residents of a continuing care senior housing community: Sociodemographic and clinical associations of cognitive, physical, and mental health. The American Journal of Geriatric Psychiatry, 27(9): 895-907. https://doi.org/10.1016/j.jagp.2019.04.002   [Google Scholar] PMid:31078382 PMCid:PMC7172111
  33. Jeste DV, Savla GN, Thompson WK, Vahia IV, Glorioso DK, Martin AVS, and Depp CA (2013). Association between older age and more successful aging: Critical role of resilience and depression. American Journal of Psychiatry, 170(2): 188-196. https://doi.org/10.1176/appi.ajp.2012.12030386   [Google Scholar] PMid:23223917 PMCid:PMC3593664
  34. Katz S and Calasanti T (2015). Critical perspectives on successful aging: Does it “appeal more than it illuminates”? The Gerontologist, 55(1): 26-33. https://doi.org/10.1093/geront/gnu027   [Google Scholar] PMid:24747713 PMCid:PMC4986584
  35. Kim ES, Grodstein F, and Kubzansky LD (2018). Optimism and healthy aging in women and men. Innovation in Aging, 2(Suppl 1): 802-803. https://doi.org/10.1093/geroni/igy023.2980   [Google Scholar] PMCid:PMC6228560
  36. Knepple Carney A, Graf AS, Hudson G, and Wilson E (2021). Age moderates perceived COVID-19 disruption on well-being. The Gerontologist, 61(1): 30-35. https://doi.org/10.1093/geront/gnaa106   [Google Scholar] PMid:32808660 PMCid:PMC7454676
  37. Lai CC, Shih TP, Ko WC, Tang HJ, and Hsueh PR (2020). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. International Journal of Antimicrobial Agents, 55(3): 105924. https://doi.org/10.1016/j.ijantimicag.2020.105924   [Google Scholar] PMid:32081636 PMCid:PMC7127800
  38. Laird KT, Lavretsky H, Wu P, Krause B, and Siddarth P (2019). Neurocognitive correlates of resilience in late-life depression. The American Journal of Geriatric Psychiatry, 27(1): 12-17. https://doi.org/10.1016/j.jagp.2018.08.009   [Google Scholar] PMid:30262406 PMCid:PMC6298796
  39. Legdeur N, Badissi M, Carter SF, De Crom S, Van De Kreeke A, Vreeswijk R, and Visser PJ (2018). Resilience to cognitive impairment in the oldest-old: Design of the EMIF-AD 90+ study. BMC Geriatrics, 18: 289. https://doi.org/10.1186/s12877-018-0984-z   [Google Scholar] PMid:30477432 PMCid:PMC6258163
  40. Li Y and Mutchler JE (2020). Older adults and the economic impact of the COVID-19 pandemic. Journal of Aging and Social Policy, 32(4-5): 477–487. https://doi.org/10.1080/08959420.2020.1773191   [Google Scholar] PMid:32543304
  41. Liu K, Chen Y, Lin R, and Han K (2020). Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. Journal of Infection, 80(6): e14-e18. https://doi.org/10.1016/j.jinf.2020.03.005   [Google Scholar] PMid:32171866 PMCid:PMC7102640
  42. Lucchetti G, Góes LG, Amaral SG, Ganadjian GT, Andrade I, Almeida PODA, and Manso MEG (2021). Spirituality, religiosity and the mental health consequences of social isolation during COVID-19 pandemic. International Journal of Social Psychiatry, 67(6): 672-679. https://doi.org/10.1177/0020764020970996   [Google Scholar] PMid:33135559 PMCid:PMC7649649
  43. MacLeod S, Musich S, Hawkins K, Alsgaard K, and Wicker ER (2016). The impact of resilience among older adults. Geriatric Nursing, 37(4): 266-272. https://doi.org/10.1016/j.gerinurse.2016.02.014   [Google Scholar] PMid:27055911
  44. Malone J and Dadswell A (2018). The role of religion, spirituality and/or belief in positive ageing for older adults. Geriatrics, 3(2): 28. https://doi.org/10.3390/geriatrics3020028   [Google Scholar] PMid:31011066 PMCid:PMC6319229
  45. Manning L, Ferris M, Narvaez Rosario C, Prues M, and Bouchard L (2019). Spiritual resilience: Understanding the protection and promotion of well-being in the later life. Journal of Religion, Spirituality and Aging, 31(2): 168-186. https://doi.org/10.1080/15528030.2018.1532859   [Google Scholar] PMid:33335455 PMCid:PMC7743140
  46. Martin AV, Eglit GM, Maldonado Y, Daly R, Liu J, Tu X, and Jeste DV (2019). Attitude toward own aging among older adults: Implications for cancer prevention. The Gerontologist, 59(Supplement_1): S38-S49. https://doi.org/10.1093/geront/gnz039   [Google Scholar] PMid:31100140 PMCid:PMC6524756
  47. Martin P, Kelly N, Kahana B, Kahana E, Willcox BJ, Willcox DC, and Poon LW (2015). Defining successful aging: A tangible or elusive concept? The Gerontologist, 55(1): 14-25. https://doi.org/10.1093/geront/gnu044   [Google Scholar] PMid:24840916 PMCid:PMC4542894
  48. Martínez-Moreno A, Ibáñez-Pérez RJ, Cavas-García FF, and Cano-Noguera F (2020). The influence of physical activity, anxiety, resilience and engagement on the optimism of older adults. International Journal of Environmental Research and Public Health, 17(21): 8284. https://doi.org/10.3390/ijerph17218284   [Google Scholar] PMid:33182468 PMCid:PMC7665151
  49. Mlinac ME, Sheeran TH, Blissmer B, Lees F, Martins D (2011). Psychological resilience. In: Resnick B, Gwyther L, Roberto K (Eds.), Resilience in aging: 67–87. Springer, New York, USA. https://doi.org/10.1007/978-1-4419-0232-0_5   [Google Scholar]
  50. Moore RC, Eyler LT, Mausbach BT, Zlatar ZZ, Thompson WK, Peavy G, and Jeste DV (2015). Complex interplay between health and successful aging: Role of perceived stress, resilience, and social support. The American Journal of Geriatric Psychiatry, 23(6): 622-632. https://doi.org/10.1016/j.jagp.2014.08.004   [Google Scholar] PMid:25217186 PMCid:PMC4329284
  51. Morrow R, Rodriguez A, and King N (2015). Colaizzi’s descriptive phenomenological method. The Psychologist, 28(8): 643-644. https://doi.org/10.1016/j.jcin.2015.03.004   [Google Scholar] PMid:25907096
  52. Musich S, Wang SS, Slindee L, Kraemer S, and Yeh CS (2019). Association of resilience and social networks with pain outcomes among older adults. Population Health Management, 22(6): 511-521. https://doi.org/10.1089/pop.2018.0199   [Google Scholar] PMid:30801238 PMCid:PMC6885755
  53. Palermo S (2021). “Neurocovid”: An analysis of the impact of COVID-19 on the older adults: Evolving psychological and neuropsychological understanding. In: Baddour MM (Ed.), Fighting the COVID-19 pandemic: 215-228. Books on Demand, Norderstedt, Germany. https://doi.org/10.5772/intechopen.99414   [Google Scholar]
  54. Polit DF and Beck CT (2016). Nursing research: Generating and assessing evidence for nursing practice. 8th Edition, Lippincott Williams & Wilkins, Philadelphia, USA.   [Google Scholar]
  55. Pruchno R and Carr D (2017). Successful aging 2.0: Resilience and beyond. The Journals of Gerontology: Series B, 72(2): 201-203. https://doi.org/10.1093/geronb/gbw214   [Google Scholar] PMid:28364520
  56. Rantanen T, Saajanaho M, Karavirta L, Siltanen S, Rantakokko M, Viljanen A, Rantalainen T, Pynnönen K, Karvonen A, Lisko I, and Palmberg L (2018). Active aging–resilience and external support as modifiers of the disablement outcome: AGNES cohort study protocol. BMC Public Health, 18: 565. https://doi.org/10.1186/s12889-018-5487-5   [Google Scholar] PMid:29716566 PMCid:PMC5930766
  57. Ranzijn R and Luszcz M (2011). Acceptance: A key to wellbeing in older adults? Australian Psychologist, 34(2): 94-98. https://doi.org/10.1080/00050069908257435   [Google Scholar]
  58. Snelgrove SR (2014). Conducting qualitative longitudinal research using interpretive phenomenological analysis. Nurse Researcher, 22(1): 20–25. https://doi.org/10.7748/nr.22.1.20.e1277   [Google Scholar] PMid:25251816
  59. Soukkio P, Suikkanen S, Kääriä S, Kautiainen H, Sipilä S, Kukkonen-Harjula K, and Hupli M (2018). Effects of 12-month home-based physiotherapy on duration of living at home and functional capacity among older persons with signs of frailty or with a recent hip fracture-protocol of a randomized controlled trial (HIPFRA study). BMC Geriatrics, 18(1): 1-10. https://doi.org/10.1186/s12877-018-0916-y   [Google Scholar] PMid:30285645 PMCid:PMC6167829
  60. Sun C, Yu Y, Li X, Cui Y, Ding Y, Zhu S, Li X, Chen S, and Zhou R (2020). The factors of adaptation to nursing homes in mainland China: A cross-sectional study. BMC Geriatrics, 20(1): 517. https://doi.org/10.1186/s12877-020-01916-x   [Google Scholar] PMid:33256628 PMCid:PMC7708906
  61. van Kessel G (2013). The ability of older people to overcome adversity: A review of the resilience concept. Geriatric Nursing, 34(2): 122-127. https://doi.org/10.1016/j.gerinurse.2012.12.011   [Google Scholar] PMid:23332474
  62. Wang JL, Zhang DJ, and Zimmerman MA (2015). Resilience theory and its implications for Chinese adolescents. Psychological Reports, 117(2): 354–375. https://doi.org/10.2466/16.17.PR0.117c21z8   [Google Scholar] PMid:26444835
  63. Wister A, Lear S, Schuurman N, MacKey D, Mitchell B, Cosco T, and Fyffe I (2018). Development and validation of a multi-domain multimorbidity resilience index for an older population: Results from the baseline Canadian longitudinal study on aging. BMC Geriatrics, 18: 170. https://doi.org/10.1186/s12877-018-0851-y   [Google Scholar] PMid:30053838 PMCid:PMC6062931
  64. Wu Z and McGoogan JM (2020). Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese center for disease control and prevention. Journal of the American Medical Association, 323(13): 1239-1242. https://doi.org/10.1001/jama.2020.2648   [Google Scholar] PMid:32091533
  65. Xu W, Li YX, and Wu C (2019). Incidence of frailty among community-dwelling older adults: A nationally representative profile in China. BMC Geriatrics, 19: 378. https://doi.org/10.1186/s12877-019-1393-7   [Google Scholar] PMid:31888498 PMCid:PMC6937935
  66. Yang Q, Wang Y, Tian C, Chen Y, and Mao J (2021). The experiences of community‐dwelling older adults during the COVID‐19 lockdown in Wuhan: A qualitative study. Journal of Advanced Nursing, 77(12): 4805-4814. https://doi.org/10.1111/jan.14978   [Google Scholar] PMid:34258806 PMCid:PMC8447433
  67. Yates TM, Tyrell FA, and Masten AS (2015). Resilience theory and the practice of positive psychology from individuals to societies. In: Joseph S (Ed.), Positive psychology in practice: Promoting human flourishing in work, health, education, and everyday life: 773-788. John Wiley and Sons, Hoboken, USA. https://doi.org/10.1002/9781118996874.ch44   [Google Scholar]
  68. Yin RK (2018). Case study research and applications: Design and methods. Sage, Los Angeles, USA.   [Google Scholar]
  69. Zach S, Zeev A, Ophir M, and Eilat-Adar S (2021). Physical activity, resilience, emotions, moods, and weight control of older adults during the COVID-19 global crisis. European Review of Aging and Physical Activity, 18: 5. https://doi.org/10.1186/s11556-021-00258-w   [Google Scholar] PMid:33648448 PMCid:PMC7917372