title: The physical, social and symbolic environment supporting the well-being of home-dwelling elderly people.
abstract: OBJECTIVE
  The purpose of this study was to construct a theory on an environment that would support the well-being of home-dwelling elderly people in northern Finland.
  
  
  METHODS
  The study was carried out according to the phases of theory formulation using both qualitative and quantitative methods.
  
  
  METHODS
  The data of the first phase consisted of focused interviews (n=39) with home-dwelling elderly people over the age of 65 years. Judgement-based snowball sampling was used. By means of inductive concept synthesis, hypothetical models were constructed of a physical, social and symbolic environment that would support the well-being of the elderly. In order to verify the concepts of the hypothetical model, an instrument was constructed in the second phase of the study and its reliability was evaluated by a panel of experts consisting of nurses (n=15), through expert evaluations (n=3) and by postal questionnaire. The final phase of the study (n=328) also targeted home-dwelling elderly people living in northern Finland. The sampling method used was a stratified random sampling. The data of (n=328) were analysed by principal component analysis (PCA) and confirmatory factor analysis (CFA).
  
  
  RESULTS
  The physical environment that supports the well-being of the elderly includes a northern environment, an environment that enables safe activity and a pleasant physical environment. The social environment that supports well-being enables the elderly to receive help, allows them to keep in contact with family members and friends as providers of support to their well-being and offers a pleasant living community. The symbolic environment that supports well-being consists of the ideal attributes of well-being, spirituality, the normative attribute of well-being and a sense of history.
  
  
  CONCLUSIONS
  Even though the environment is artificially divided into separate areas in the theory, in putting the results into practice, it needs to be taken into account that observing separate areas of the environment does not provide a comprehensive view on the connection between environment and well-being.
authors.affiliation: Department of Health Sciences, University of Oulu, Oulu, Finland.
authors.forename: Satu
authors.initials: S
authors.lastname: Elo
authors.forename: Reetta
authors.initials: R
authors.lastname: Saarnio
authors.forename: Arja
authors.initials: A
authors.lastname: Isola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004777:Environment; D005260:Female; D005387:Finland; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012931:Social Environment; D012944:Social Support; D029181:Spirituality