Volume 19, Issue 2 (Summer 2024)                   Salmand: Iranian Journal of Ageing 2024, 19(2): 158-175 | Back to browse issues page


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Naseh L, Mohammadi-Shahboulaghi F, Khankeh H R, Norouzi Tabrizi K. Successful Aging: Concept Analysis with Walker and Avant's Approach. Salmand: Iranian Journal of Ageing 2024; 19 (2) :158-175
URL: http://salmandj.uswr.ac.ir/article-1-2623-en.html
1- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
2- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. , f.mohammadi@uswr.ac.ir
3- Department of Nursing, Health in Emergency and Disaster Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
4- Department of Nursing, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Introduction
In today’s era, following the emergence of the global phenomenon of aging, the health of the elderly was ranked among the most important challenges of the world health system [4]. Following the emergence of new concepts in the literature on aging, one of the most used of these concepts in the last two decades is successful aging [6, 7]. Since the emergence of this concept, more than 100 definitions have been provided for it [10], but there is still no single definition. Accordingly, and considering that the concept analysis tries to differentiate it from other similar concepts by investigating and deeply analyzing the determining and irrelevant characteristics of a concept [21], the present study was conducted to analyze the concept of successful aging with Walker and Avant’s approach, in order to better understand the characteristics, antecedents, and consequences of successful aging, achieve semantic integrity and clarify this concept to help increase stability in its application.

Methods
This concept analysis study was conducted using the 8-step Walker and Avant’s approach (2019) in 2022. Databases, including Scientific Information Database (SID), Magiran, Noormags, Web of Science, PubMed, Scopus, and ProQuest were searched for papers published during 2000-2022 using the keywords, such as aging, successful aging, and related concepts, including “active aging”, “healthy aging”, “positive aging”, “productive aging” and their equivalent English terms. The inclusion criteria were articles in Persian and English on successful aging, reporting implicitly and objectively about the characteristics, antecedents, and consequences of successful aging, available full text, and no duplication. From the total of 4163 articles found, 83 articles were finally selected and analyzed using Granheim and Lundman’s content analysis method. 
The results, discussion, and conclusion sections of the selected articles were carefully read several times by the main researcher and then, the sections containing the words and expressions used to define or describe the antecedents, characteristics, and consequences of the concept of successful aging were extracted from them as a specific semantic unit and primary codes (a total of 994 primary codes were obtained). In the next step, by comparing and categorizing these codes, subclasses, and main classes were extracted, respectively. To ensure the validity and strength of content analysis data, Lincoln and Guba’s criteria (1985) were used to determine credibility and confirmability. For credibility, a long engagement with the data extracted from the articles and spending a long time analyzing them was used. For confirmability, extracted semantic units, primary codes, subcategories, and categories were regularly available to researchers expert in qualitative analysis and gerontology to confirm the correctness of the data and make the necessary corrections.

Results 
Various applications of successful aging were investigated and reported in the existing literature. The content analysis of 83 selected articles revealed the following 7 categories as the main features of the concept of successful aging: 1) “a manageable process”, 2) “multidimensional and inclusive”, 3) “ socio-cultural context-based”, 4) having physical, psychological and social health”, 5) “non-dependence on others”, 6) “happiness”, and 7) “continuity and active participation in life”. In this study, classes of positive personal characteristics, effective adaptation to old age, underlying factors related to health status, family underlying factors, favorable socio-economic cultural conditions, and favorable environmental conditions were extracted as antecedents of successful aging. Also, the consequences of successful aging included preserving the dignity of the elderly, spiritual excellence, being a role model for others, reducing healthcare costs, and improving the quality of life (Figure 1).

Also, the review of existing studies showed that although successful aging has a rich research background, few studies have measured it using specialized tools and most of the studies have used non-specialized tools. Therefore, considering the importance of successful aging at a time when researchers of different countries are focused on it due to the phenomenon of aging, providing a comprehensive and practical definition of this concept can be fruitful for designing more accurate and practical tools.

Conclusion
The aim of the present study was to extract the defining characteristics of the concept of successful aging and its various applications in the existing literature in order to provide a comprehensive definition to help operationalize and measure this concept. According to the sum of the extracted applications, it is concluded that the definition of this concept has gradually evolved and moved from objective definitions focused on biomedical factors and especially, freedom from disability and disease to subjective definitions focused on well-being, social participation, and adaptation processes. As a result, today this concept is depicted by a wide set of biological, psychological, social, and environmental factors.
Also, based on the present analysis, it can be said that successful aging is a guidable and context-based process and consists of physical, psychological, social, and spiritual dimensions, which require the physical, psychological, and social health of the elderly, lack of dependence on others, happiness, continuity and active participation in life. For successful aging, positive individual characteristics, effective adaptation to old age, health-related factors, family support, favorable socio-economic and cultural conditions, as well as a conducive environment, all play crucial roles. Successful aging helps maintain the dignity of the elderly, spiritual excellence, becoming a role model for others, reducing healthcare costs, and improve the quality of life of the elderly (Figure 1). 

Ethical Considerations
Compliance with ethical guidelines

In this study, all publication ethics were considered.

Funding
This article was extracted from a classroom project of philosophy and theorizing course in nursing. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Authors' contributions
The authors contributed equally to preparing this paper.

Conflicts of interest
The authors declared no conflicts of interest.

Acknowledgements
The authors would like to thank the professors of philosophy and theorizing course for guiding through the research.



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Type of Study: Research | Subject: gerontology
Received: 2023/05/04 | Accepted: 2023/06/20 | Published: 2024/07/01

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