Chapter 5. Phase II: Leisure participation profile of older adults
5.4. Data analysis
well-being, and quality of life. The inclusion criteria were (1) older adults aged more than 60 years and (2) being capable of communicating in Mandarin Chinese or Taiwanese Hokkien. Those with severe brain injury, dementia, and other cognitive-related diseases were excluded.
4.1.5.2. Measures:
Leisure Participation Questionnaire developed in phase I was used.
4.1.5.3. Procedure:
We contacted the directors of the community colleges and senior associations through telephone and email to give brief introduction of our research. After getting the permission to get access to older adults, we made appointments for visiting the
community sites. The directors excluded those who have cognitive-related diseases, such as dementia. We explained our research purpose and procedure to older adults, after obtaining their informed consents, the participants filled out the Leisure
Participation Questionnaire with the assistance of the researcher. It took approximately twenty minutes for each participant to complete the questionnaire. For the test-retest reliability study, thirty older adults underwent two administrations of the LPQ with an interval of 4 weeks.
4.1.5.4. Data analysis:
The internal consistency of three of the six dimensions of the LPQ, including
Frequency, Preference and Value, were examined by computing Cronbach’s α.
Test-retest reliability was examined by Pearson’s coefficient for continuous variables, including Frequency, Preference and Value, and Spearman’s rho for ordinal variables, including Diversity, With whom and Where.
4.2. Results
4.2.1. Contents of Leisure Participation Questionnaire
The Leisure Participation Questionnaire has 31 activity items (Appendix 2).
Leisure Participation Questionnaire measures six dimensions, including Diversity, Frequency, With whom, Where, Preference and Value. The ratings of each dimension
are described as follows (Appendix 3):
Diversity: “Over the past three months, have you ever participated in this
activity?” (1) yes, (2) no.
Frequency: “How often?” (1) once every three months, (2) once every two
months, (3) once a month, (4) every three weeks, (5) every two weeks, (6) once a week, (7) two-five times a week, (8) once a day, (9) more than once a
day.
With whom: “With whom do you do this most often?” (1) alone, (2) with
nuclear family members, (3) with relatives, (4) with friends, (5) others.
Where: “Where do you do this most often?” (1) at home, (2) at relatives’
home, (3) at friend’s home, (4) within 30 minutes, (5) more than 30 minutes.
Preference: “How much do you like this activity?” (1) not at all, (2)
somewhat/sort of, (3) pretty much, (4) very much, (5) love it.
Value: “How much do you value this activity?” (1) not at all, (2)
somewhat/sort of, (3) pretty much, (4) very much, (5) extremely important.
4.2.2. Interpretation of the ratings
By administering the Leisure Participation Questionnaire, researchers can have a
clear profile of older adult’s leisure participation.
Diversity: By adding up the number of activity items that the older adult ticks
“yes”, researchers can understand how many leisure activities the older adult
participated in.
Frequency: The mean of frequency is obtained by adding up the ratings of the
frequency, and then divided by the total number of the activity items being participated in. Base on the frequency, researchers can understand how often
the older adult has participated in leisure activities over the past three month.
With whom: By calculating the percentage of each of the five ratings,
researchers can know who accompanies the older adult most often when he/she participates in leisure activities, giving initial information about one’s
social network.
Where: By calculating the percentage of each of the five ratings, researchers
can know where the older adult usually goes for leisure activities , giving information about whether he/she tends to be homebound or is able to
participate in the community.
Preference: By calculating the mean of ratings of preference, researchers
can know the overall preference among the leisure activities that the older
adult participated in.
Value: By calculating the mean of the ratings of value, researchers can
understand how the older adult values these leisure activities that he/she has participated in.
With further investigation, the Diversity, Frequency, Preference and Value dimensions can be interpreted together by each item. In this way, researchers can have more detailed information and a clearer view of whether the older adult has participated in the leisure activities that he/she liked as frequent as possible. The underlying factors that hinder or support the older adult’s leisure participation can be documented through interview. Furthermore, health professionals, such as occupational therapists can help solve the possible barriers through intervention, in order to improve more active participation in leisure activities for the older adult.
4.2.3. Internal consistency of the LPQ
The analysis of internal consistencies of the three dimensions of the LPQ,
including Frequency, Preference and Value, which were all continuous variables, were performed (N=149). Cronbach’s α for the Frequency dimension was .792, .794 for the Preference dimension, and .799 for the Value dimension. Cronbach’s α of all three dimensions reached .70, indicating acceptable internal consistency (Table 2) (Cronbach, 1951).
4.2.4. Test–retest reliability of LPQ
Table 3 presents the results of test-retest reliability of all six dimensions of the
LPQ, with a sample of thirty older adults. Among them, four dimensions, including Diversity (ρ=.619), Frequency (r =.718), With whom (ρ=.717) and Where (ρ=.660),
showed moderate to high test-retest reliability. In addition, the dimensions of Preference (r=.370) and Value (r=.387) were rated as low test-retest reliability (Streiner & Norman, 2003).
Chapter 5. Phase II: Leisure participation profile of older adults
5.1. Participants
Older adults were recruited from different community locations in Northern Taiwan. These community locations, including community colleges for the elderly and
senior associations, which held different programs to improve or enhance older adults’
health, well-being, and quality of life. The inclusion criteria were (1) older adults aged more than 60 years and (2) being capable of communicating in Mandarin Chinese or Taiwanese Hokkien. Those with severe brain injury, dementia, and other
cognitive-related diseases were excluded.
5.2. Measures
Older adults’ leisure participation was measured by Leisure Participation
questionnaire, which was developed in phase one. Leisure Participation Questionnaire (LPQ) measures six dimensions, including Diversity, Frequency, With whom, Where, Preference and Value. This questionnaire includes 31 activity items in total.
5.3. Procedure
We contacted the directors of the community colleges and senior associations through telephone or email to give brief introduction of our research. After getting the permission to get access to the older adults, we made appointments for visiting the community sites. The directors excluded those who have cognitive-related diseases, such as dementia. We explained our research purpose to older adults, and after they agreed to join in, they signed an informed consent form before filling out the
questionnaire. The participants filled out the Leisure Participation Questionnaire with
the assistance of the researcher. It took approximately 20 minutes for participants to complete the questionnaire.
5.4. Data analysis
Descriptive analysis was conducted to characterize the basic properties of demographic data and all six dimensions in the Leisure Participation Questionnaire.
Categorical variables include Diversity, With whom and Where, and these are presented as percentages. As to continuous variables, Frequency, Preference and Value were presented as means and standard deviations (SD).
Age, education level and level of frailness were regrouped respectively. T-tests were conducted to examine group differences in the six dimensions of the Leisure Participation Questionnaire.
5.5. Results
5.5.1. Characteristics of participants
The characteristics of the participants were presented in Table 1. The 149 older adults ranged in age from 60 to 88 years old (mean=70.7; SD=6.35). 83.9% were women; 81% lived with their family. 57.7% of the participants were married; the others were single, divorced or widowed. Over 60% of the participants had more than 9 years of education; 1% of the participants were supported by government subsidy. In terms of
health, 20.8% of the participants had no past medical history, 70.2% reported at least one disease. As to level of frailty, 45% of the participants were categorized as level 1
and 2, indicating good health status.
5.5.2. Overall leisure participation profile
5.5.2.1. Diversity
The average number of activity items that older adults participated in were 15.76
(SD=4.40) (Table 5). Presented in Table 4, the most common leisure activities were
“chatting” and “getting together with families and friends”, both reported by 99.3% of
the participants. The second highest leisure activity was “watching TV/movies (96.6%)”, and the third was “going shopping (92.6%)”. The least participated leisure activities were all physical activities, including “running (12.1%)”, “playing ball games (9.4%)”
and “swimming (8.1%)”.
5.5.2.2. Frequency
The ratings of frequency is from 1 to 9, and the average frequency of leisure participation of older adults among the 31 activity items is 3.24 (SD=0.93), which is between “Once every month” and “Once every three weeks” (Table 5). Table 6 indicates the highest reported percentage of frequency of each activity item. Among the 31 items, the top two activities that older adults participate in “More than once a day” are “Watch TV/movies (62.4%)” and “Use electronic devices/gadgets (58.4%)”. As to the top two
activities that older adults participate in “Once a day” are “Read magazines/books (41.6%)” and “Go for a walk (34.9%)”. For the rating “Once every three months”, the top two activities that older adults participate in are “Travel (33.6%)” and “Go to concerts/exhibitions (20.8%)”.
5.5.2.3. With whom
In Table 5, among the five with whom ratings of all leisure activities, older adults participated in leisure activities “On one’s own (39.2%)” the most, followed by “With friends (32.3%)”. Table 6 shows the highest percentage of the rating of each activity item in the “With whom” dimension. Activities that older adults participate in most
often with friends are the activities of “Chatting with others (89.3%)”, and followed by
“Getting together with friends and family (77.9%)”. Activities that older adults
participate in most often on one’s own are the activities of “Shopping (79.2%)”, and followed by “Use electronic devices/gadgets (76.5%)”.
5.5.2.4. Where
Among all leisure activities, older adults tend to participate in leisure activities at home (36.76%) and at locations within 30 minutes (36.17%), and the least frequent were at relatives’ home (2.08%) and friend’s home (3.58%) (Table 5). In Table 6, the top two activities that older adults participate in most often at home are the activities of
“Watch TV/movies (91.3%)” and “Use electronic devices/gadgets (78.5%)”. As to the
top two activities that older adults participate in most often at locations within 30 minutes include the following activities: “Shopping (82.6%)” and “Going for a walk (71.8%)”. Activities that older adults participate in most often at locations more than 30 minutes are “Travel (78.5%)”, “Go mountain climbing (38.9%)”.
5.5.2.5. Preference
The mean of the Preference dimension among all leisure activities was 3.48
(SD=0.43) (Table 5). The level of Preference of each leisure activity was between
“pretty much (coded as 3)” and “very much (coded as 4)”.
5.5.2.6. Value
The mean of the Value dimension among all leisure activities was 3.44 (SD=0.45) (Table 5). The level of Value of each leisure activity was between “pretty much (coded as 3)” and “very much (coded as 4)”.
5.5.3. Age differences in leisure participation profile
The mean age of our participants was 70.7 years old (SD=6.35), therefore, the older adults were separated into two groups, i.e., the group of young-old was aged
below 70 years (52.3%), and the group of the old-old was aged above 70 years (47.7%).
5.5.3.1. Diversity
The activity that the young-old participated in the most were getting together with friends and family (100%) and chatting (100%), and the least was swimming (7.7%)
(Table 7). In the old-old group, the most common leisure activity were getting together with friends and family (98.6%) and chatting (98.6%), and the least were swimming (8.5%) and jogging (8.5%) (Table 7).
The age differences of the Diversity dimension among all leisure activities between the young-old and old-old group was statistically significant (p<.05), indicating that the young-old participated in more leisure activities in total (Table 8).
5.5.3.2. Frequency
In Table 8, the mean of Frequency dimension of the young-old and old-old group was 3.39(SD=0.88) and 3.07(SD=0.95) respectively. The age differences of the Frequency dimension among all leisure activities between the young-old and old-old group were statistically significant (p<.05), indicating that the young-old participated in leisure activities with higher frequency in total than the old-old.
5.5.3.3. With whom
In the With whom dimension, the mean of “On one’s own” was the highest among the five ratings in both groups, which were 0.39(SD=0.13) for the young-old group and 0.40(SD=0.13) for the old-old, indicating that in all leisure activities, both groups tend to participate in activities on their own. There were no significant group differences among the five ratings (Table 8).
5.5.3.4. Where
In the Where dimension, there were significant group differences among the rating “Within 30 minutes (p<.05)”, indicating that the young-old group participated more at locations within 30 minutes. As to the rating “More than 30 minutes”, there were also significant group differences (p<.05), showing that the old-old group participated more at locations more than 30 minutes (Table 8).
5.5.3.5. Preference
The level of Preference of all leisure activity domains were between “pretty much (coded as 3)” and “very much (coded as 4)”, and there were no significant differences between the groups of young-old and old-old (Table 8).
5.5.3.6. Value
Among the two groups, the level of value of all leisure activity domains were between “pretty much (coded as 3)” and “very much (coded as 4)”, and there were no significant differences between the groups of young-old and old-old (Table 8).
5.5.4. Differences in Leisure participation profile between the healthy and frail older adults
Level of frailness was defined by the Canadian study of health and aging clinical frailty scale (CSHA-CFS) Chinese in-person interview version. From low to high level of frailness, CSHA-CFS is rated as level one to seven. In this research, we categorized older adults who were rated as level one and two as healthy older adults, coded as 1, and
those whose levels were three to seven as frail older adults, coded as 2. Of all participants, eighty-two (55%) participants were rated as frail older adults.
5.5.4.1. Diversity
The leisure activity that the frail group participated in the most was getting together with friends and family (100%), and the least was swimming (7.3%). As to healthy group, chatting (100%) was the leisure activity that they participated in the most, and the least was playing ball games (7.5%) (Table 9). The Diversity dimension among all leisure activities between the healthy and frail group showed no significant
differences (Table 10).
5.5.4.2. Frequency
In Table 10, the mean of Frequency dimension of the healthy and frail group were 3.29(SD=0.82) and 3.20(SD=1.01). There were no significant group differences in the Frequency dimension among the two groups of healthy and frail.
5.5.4.3. With whom
In the With whom dimension, the mean of “On one’s own” was the highest among the five ratings in both groups, which were 0.40(SD=0.13) for the healthy group and 0.38(SD=0.13) for the frail group, indicating that in all leisure activities, both groups tend to participate in activities on their own. There were no significant group differences among the five ratings (Table 10).
5.5.4.4. Where
In the healthy group, the mean of the rating “Within 30 minutes (Mean=0.37, SD=0.14)” was the highest among the five ratings, while in the frail group, the mean of the rating “At home (Mean=0.37, SD=0.11)” was the highest. Among the five ratings of the dimension Where, there were no significant group differences (Table 10).
5.5.4.5. Preference
The level of Preference of overall leisure activities were between “pretty much (coded as 3)” and “very much (coded as 4)”. The mean rating for the Preference dimension of the frail group was 3.44(SD=0.41) and the healthy group was
3.51(SD=0.45). Among these two groups, there were no significant group differences (Table 10).
5.5.4.6. Value
Among the two groups, the level of value of all leisure activities were between
“pretty much (coded as 3)” and “very much (coded as 4)”.The mean rating for the Value
dimension of the frail group was 3.42(SD=0.46) and the healthy group was
3.46(SD=0.45). There were no significant differences between two groups (Table 10).
5.5.5. Differences in leisure participation profile differences between low and high-education levels
According to the 9-year compulsory education system in Taiwan, participants were
categorized into two groups. 63.8% of the older adults had received more than 9 years of education, coded as “high-education group”. 4% of the older adults had never gone to school and 32.2% of them received less than 9 years of education, which were both coded as “low-education group”.
5.5.5.1. Diversity
The leisure activity that the high-education group participated in the most was getting together with friends and family (100%), and the least is playing ball games (9.5%). As to the low-education group, chatting (100%) was the leisure activity that they participated in the most, and the least was swimming (3.7%) (Table 11).
In Table 11, overall, the high-education group participated in more leisure activities than the low-education group, and has showed significant differences (p<.01).
5.5.5.2. Frequency
The mean of the Frequency dimension of the high-education and low-education groups were 3.52(SD=0.84) and 2.75(SD=0.86) respectively. The high-education group participated more often in leisure activities than the low-education group, showing statistically significant differences among two groups (p<.01) (Table 12).
5.5.5.3. With whom
In the With whom dimension, the mean of “On one’s own” was the highest among the five ratings in both groups, which were 0.39(SD=0.12) for the high-education group
and 0.40(SD=0.14) for the low-education group, indicating that in all leisure activities, both groups tend to participate in activities on their own. There were no significant group differences among the five ratings (Table 12).
5.5.5.4. Where
In the Where dimension, the mean of the rating “At home” was the highest among the five ratings in both groups, which were 0.37(SD=0.09) for the
high-education group and 0.37(SD=0.13) for the low-education group. Among the five ratings of the dimension Where, there were no significant group differences (Table 12).
5.5.5.5. Preference
Overall, the levels of preference of leisure activities were between “pretty much (coded as 3)” and “very much (coded as 4)” in both groups. The mean rating of the high-education group was 3.47(SD=0.43), while the low-education group was
3.48(SD=0.43). Among these two groups, there were no significant differences between all four activity domains (Table 12).
5.5.5.6. Value
Overall, the levels of Preference of leisure activities were between “pretty much (coded as 3)” and “very much (coded as 4)” among both groups. The mean rating for the Value dimension of the high-education group was 3.45 (SD=0.47) and the
low-education group was 3.44(SD=0.41). Level of value in all four activity domains
showed no significant differences between two groups (Table 12).