title: Self-transcendence (ST) among very old people--its associations to social and medical factors and development over five years.
abstract: OBJECTIVE
  The aims of this study were to describe the associations between ST and psychological and physical wellbeing among oldest old people and to test the influence of negative life events on ST, and the predictive value of the self-transcendence scale (STS) for mortality.
  
  
  BACKGROUND
  ST has been identified as a valuable resource for transcending psychological and physical suffering and has been related to psychological wellbeing and higher quality of life.
  
  
  METHODS
  The study design was correlational, prospective, and longitudinal.
  
  
  METHODS
  The participants were recruited from a medium-sized town and from an adjacent rural area in northern Sweden.
  
  
  METHODS
  The sample consisted of 190 participants (123 women and 67 men) who completed the STS. At a 5-year follow-up, 55 people (29.5%) were alive and able to complete the assessments again.
  
  
  RESULTS
  ST was positively associated with psychological wellbeing, self-rated health, having someone to talk with and being able to go outdoors independently. Diagnoses of depression, dementia disease, and osteoporosis were associated with lower STS scores as were living in a residential care facility, and feeling lonely. There was a significant relationship between the index of negative life events and ST between baseline and follow-up. More negative life events were associated with a larger decline in STS scores over five years.
  
  
  CONCLUSIONS
  ST is an important source for wellbeing among the oldest old, and the accumulation of negative life events might threaten the ability to transcend setbacks.
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden; Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden.
authors.forename: Astrid
authors.initials: A
authors.lastname: Norberg
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden. Electronic address: Lundman@umu.se.
authors.forename: Berit
authors.initials: B
authors.lastname: Lundman
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Yngve
authors.initials: Y
authors.lastname: Gustafson
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden.
authors.forename: Catharina
authors.initials: C
authors.lastname: Norberg
authors.affiliation: Department of Nursing, Umeå University, Umeå, Sweden; Department of Nursing Education, Åland University of Applied Science, Mariehamn, Åland, Finland.
authors.forename: Regina Santamäki
authors.initials: RS
authors.lastname: Fischer
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
authors.forename: Hugo
authors.initials: H
authors.lastname: Lövheim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008132:Loneliness / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009341:Negativism; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D012944:Social Support; D029181:Spirituality; D013548:Sweden
keywords: Depression; Negative life-events; Oldest old; Self-transcendence