Effect of Psychomotor Program on Self-Esteem and Cognitive Ability of the Elderly Women

 

Yun Jung Kim*, Youn Tae Suh

Adapted Physical Education, Hanshin University, Osan, 18101, Rep. of Korea

 

ABSTRACT:

Background/Objectives: Among characteristics of the elderly, there is an intimate correlation between the characteristics of physical activity and mental health, therefore mental health status gets better as physical activity gets fine. Methods/Statistical analysis: The study also provided to increase the enhancement of senior health-care and make the baseline data. Research methods include, the subjects were 65 years old and upward elder women, 20 persons classified by random sampling. Psychomotor program was performed for 90 minutes per session, twice a week during 12 weeks, for 24 session in total. Analysis of the data was by use for two dependent samples t-test of descriptive statistics. Findings: The comparison of the results of this research and previous researches led to conclusions: As a result from investigating the difference in pre/post-test between the experimental group with application of the psychomotor program and the comparison group with no application of psychomotor program, average value of self-esteem in the experimental group showed significant difference, and the change of cognitive ability in the experimental group was statistically significant. It indicates that application of psychomotor program is effective on enhancement of self-esteem and cognitive ability of the elderly women. As a result from investigating the difference in pre/post-test between the experimental group with application of the psychomotor program and the comparison group with no application of psychomotor program, average value of self-esteem in the experimental group showed significant difference, and the change of cognitive ability in the experimental group was statistically significant. It indicates that application of psychomotor program is effective on enhancement of self-esteem and cognitive ability of the elderly women.

Improvements/Applications: This research suggests that the psychomotor program which helps improving self-esteem and sociality is an appropriate program for the elderly women to live a healthy and enjoyable life.

 

 

 

 

1. INTRODUCTION:

The problem of the aged in Korea has been raised as a region of social interest since the 1970s. It is expected to be more serious as our country is becoming an aging society recently. The speed at which Korea has been becoming aged is the world's fastest now.

According to 'In 2013 Elderly person statistics' from Statistics Korea, which announced the seriousness of population aging in Korea, the population of old people aged 65 and older accounts for 12.2% of the total population, about 613 million people, exceeding 600 million for the first time since demographics. As continuously increasing every year from 3.1% in 1970, it is estimated to be over 1,000 million by 2025, 1226 million (24.3%) in 2030, finally at close to 2,000 million (37.4%) in 2050. Korea is predicted to become a super-aged society and the percentage of old people aged 65 and older of the total population will be 20.8% in 2026. It is expected to account for 32.3% in 2040, ranking the world's second country after Japan (34.5%)¹.

 

Among characteristics of the elderly, there is an intimate correlation between the characteristics of physical activity and mental health, therefore mental health status gets better as physical activity gets fine. Enhancing their physical ability by improving daily life status and regular physical activity will be an effective way to positively affect the quality of their life for improving mental health and for enjoyable later life, said Jae Woo Park, Byung Deog Hwang². In case of senile dementia, acceleration of the ageing process, such as decline in function of scala vestibular, muscular atrophy, decrease in athletic ability, causes disorder in balance, which is necessary in walking ability and stability for movement. As unstable walk shape and decrease in speed, postural instability increase the risk of falls, the vicious circle of loss of independence and various cardio-cerebrovascular diseases keeps repeating³.

 

Also, social isolation caused by anxiety of movement and loss of self-confidence, leads to poor health⁴. Self-esteem is an important factor for these elderly people to perform their daily tasks by themselves and to enjoy their old ages. According to the report of Rosenberg in 1986, self-esteem is defined as to realize that the way one treats oneself is positive and correct, and to appreciate how to value oneself. People of high self-esteem live their life with progressiveness and vitality regarding all their behaviors and life activities as worthwhile and rewarding, however, people of low self-esteem torture themselves to have a sense of inferiority regarding themselves as worthless and useless people⁵.

 

Psychomotoricity is defined as a 'physical activity' to achieve holistic development through voluntary experience, not ability- or merit-based arbitration, by improving one's confidence and expressing oneself, which is suitable for holistic and human-centered physical education ^{6, 7.} The most important factor in psychomoricity is self-esteem, psychological emotion to live one's life in a more positive way, to form a positive interpersonal relationship and successful aging. Some of the factors affecting self-esteem are economic satisfaction, career, social status, social role and so on. Health, activity of daily living and sociality such as participating in social and religious activities, are the critical factors to improve one's self-esteem⁸, As mentioned in a previous research about that self-esteem after reaching adulthood can be changed by various social experiences and interactions, social intercourse and formation of interpersonal relationship are needed for improving self-esteem, to further accomplish successful aging.

 

Cognitive ability is defined as an ability to understand things happening around us, an ability to determine problem and make a decision with circumstantial judgment and an ability to adapt oneself to the environment. Malfunction of cognitive ability is one of the serious problem in the aging process⁹.

 

The elderly women with depressed cognitive function show physical condition lacking in their stability, such as falling¹⁰.

 

Preceding studies about the elderly women have shown a steadily growing trend of the aged population and majority of studies about cognitive ability of the elderly have been mainly focusing on analyzing the cognitive enhancement of the aged especially the aged with dementia¹¹,¹². The reason of focused studies about dementia, one of the senile diseases, is that the senescence becomes unstable and daily life of the elderly is affected by depressed cognitive function caused by aging¹³.

 

Symptoms which belong to the symptoms related to dementia, including depressed cognitive function and failure of one's memory, confusion or delusion, inhibit the activity of daily living of patient1¹⁴, Depressed activity of one's daily living caused by dementia, mentioned above, is a factor decreasing self-esteem¹⁵.

 

Hereupon, this research was aimed to help the elderly live a healthy life and provide basic evidence for establishing a psychomotor program for the elderly by demonstrating the effect of the program on elderly women's self-esteem and cognitive ability.

 

Hypotheses of this research are; First, self-esteem of the experimental group who participated in psychomotor program will be enhanced compared to the comparison group.

 

Second, cognitive ability of the experimental group will be improved compared to the comparison group.

 

2. MATERIALS AND METHODS:

2.1. Subjects:

The subject was composed of elderly women who expressed voluntary participation in the research. For sampling, 40 elderly women who expressed hope for participation were selected randomly, 20 women who were able to participate in the program were classified as an experimental group and 20 women who were suitable for measurement but not for participating the program were classified as a comparison group. Contents and purpose of this research were fully explained and the agreements of participation from all participants were received. Participants were educated to keep their everyday life as usual and refrain from taking part in a new exercise program during participating in our psychomotor program to control exogenous variables which affect experimental results. The final experimental group was composed of 16 women and the final comparison group was composed of 14 women, excluding 4 from the experimental group and 6 from the comparison group who additionally took part in another exercise program, who were absent from the program 3 times or more, and who couldn't participate in pre- or post-test among the original member of the experimental and comparison group,

 

2.2. Research Plan:

To investigate how psychomotor program affects self-esteem and cognitive ability, two research factors of this research, the interview measurement of self-esteem and cognitive ability for elderly women aged 65 and over was performed before and after the program. The psychomotor program was performed for 90 minutes per session, twice a week during 12 weeks, for 24 sessions in total. Nonequivalent control group pre/post test design was applied to analyze the effect of psychomotor program on self-esteem and cognitive ability of elderly women.

 

2.3. Psychomotor program:

The psychomotor program applied in this research was set up for elderly women to enjoy the program and move their bodies voluntarily, with reference to the program applied for the elderly^16, the physical activity program applied for disabled teenagers¹⁷and motivation and relaxation for psychomotor of children written by Zimmer¹⁸.

 

2.4. Measurement scales and methods:

2.4.1. Self-esteem scale:

Self-esteem scale (RSES) was designed to measure one's self-esteem by Rosenberg¹⁹.

 

Total 10 questions were composed of 6 positive questions and 4 negative questions. Answers for negative questions were graded by inverse operation. As a result, the higher the total score was, the higher one's self-esteem was. From ‘strongly agree (4)’ to ‘strongly disagree (1)’ out of 4-point, the range of replies was between 10-point and 44-point on Likert-type scale. The reliability of results was α=0.733 according to Cronbach's alpha.

 

2.4.2 Cognitive scale:

Revised Hasegawa Dementia Scale whose validity and reliability were studied by Kim Ki-woonget al.²⁰ was applied in this research. Cronbach's alpha was 0.948. According to total points, grades of dementia were classified as following; non-dementia (24.45±3.60), slight (17.85±4.00), severity (14.10±2.83), extreme (9.23±2.83), and the highest degree (4.75±2.95).

2.4.3. Measuring method:

One-to-one interview was performed by 3 examiners who were previously trained for the measurement scales to make up for the difficulties in participation caused by presbyopia and low reading ability of the elderly.

 

2.5. Data analysis:

SPSS (version 18.0 Korea) was used in this research, and homogeneity test between two groups was performed using percentage and t-test from general characteristics of participants. In addition, pre/post-test matching sample t-test between the experimental and comparison group was applied to analyze difference between two groups. The limitation of the level of significance for all statistics was set as α=0.05.

 

3. RESULTS AND DISCUSSION:

3.1. Results:

3.1.1 Self-esteem:

As a result of pre/post-test matching sample t-test about self-esteem of elderly women felt by themselves shown in Table 1.average was -1.19, deviation was 3.39, t-value was -1.40 and significance probability (P-value) was 0.18 in the experimental group, while average was 0.03, deviation was 1.86, t-value was 1.87 and significance probability was 0.08 in the comparison group. Results from both experimental and comparison groups were not statistically significant (p<0.05), however, as shown in Table 2, average of the experimental group was increased from 29.00 in pre-test to 30.19 in post-test, showing the increase of 1.19 in average, while average of the comparison group was decreased from 27.14 in pre-test to 26.21 in post-test, showing the decrease of 0.93 in average.

 

Table 1.  Result of pre/post-test matchingt-test self-esteem of elderly women

	mean	S	T	F	P
Experimental group pro- post	-1.19	3.39	-1.40	15	.18
Comparative group pro- post	.93	1.86	1.87	13	.08

 

Table 2. Self-esteem Experimental group, Comparative group pro/post descriptive statics

	M	N	S
Experimental group pro	29.00	16	4.367
Experimental group post	30.19	16	4.053
Comparative group pro	27.14	14	4.865
Comparative group post	26.21	14	5.423

 

3.1.2 Cognitive ability:

As a result of pre/post-test matching sample t-test about cognitive ability of elderly women shown in Table 3, average was -2.19, deviation was 3.18, t-value was -2.74 and significance probability (P-value) was 0.01 in the experimental group, while average was 0.29, deviation was 1.20, t-value was 0.89 and significance probability was 0.39 in the comparison group. P-value of the experimental group was 0.01 with the statistical significance (p<0.05), however, data of the comparison group was statistically not significant. In addition, as shown in Table 4, average of the experimental group was increased from 25.56 in pre-test to 27.75 in post-test, showing the increase of 2.19 in average, while, average of the comparison group was decreased from 24.50 in pre-test to 24.32 in post-test, showing the decrease of 0.29 in average.

 

Table 3.  Result of pre/post-test matchingt-test cognitive ability of elderly women

	mean	S	t	F	P
Experimental group pro- post	-2.19	3.18	-2.74	15	.01*
Comparative group pro- post	.29	1.20	.89	13	.39

 

Table 4. cognitive Experimental group, Comparative group pro/post descriptive statics

 

3.2. Discussion:

Among previous studies, ParkJae Woo, Hwang Byung Deog²¹, reported that there was a significant correlation between characteristics of physical activity and mental health, therefore, mental health got better as the physical activity got fine as a conclusion of their research about mental health of the elderly with chronic illness related to characteristics of physical activity, This explanation is in the same line with our research that suggests possibility of positive effects of participation in holistic, human-oriented, physical activity-centric psychomotor program on self-esteem and cognitive ability.

 

In regard of the elderly's self-esteem that felt by themselves, according to the study of Kim JaeHyun²² which reported that depression, social adaptation, leisure satisfaction, satisfaction in the elderly's life which were related to characteristics of leisure activity participation, the group of elderly who participated in motoric activity with moving their bodies showed the highest statistical significance in interpersonal relationship and economic life. This explanation is consistent with our results that the experimental group who participated in psychomotor program showed more positive result in average compared to that of the comparison group.

 

Among the preceding studies of self-esteem, KimYoung Gil²³and Kim Hyungnam²⁴ reported that quality of the elderly's life declined as they got older, which is not consistent with our results, However, Kim Young Gil ²³, Choi Yunjin²⁵ reported that the quality of the elderly's life was improved as their self-esteem got higher, regardless of their age. This explanation is consistent with our result suggesting that self-esteem can be improved by voluntary participation in movement activity regardless of one's age.

 

In the results of this research, the result showed statistical significance in cognitive ability of the experimental group. In comparison with previous studies, our result about the relation between cognitive ability and exercise of the elderly is consistent with the report that exercise significantly enhanced cognitive ability²⁶, however, not consistent with the result that there was no positive effect on cognitive ability of dementia patients after treadmill exercise for 8 weeks²⁷. The reason of this different results compared to the previous studies might be caused by characteristics of psychomotor program that leads participants to express their own opinion, voluntarily take part in movements, and requires enjoyment and creativity rather than physical education which mainly aims at functional improvement.

 

Lee Byung Hee, Park Joon Soo and Kim NaRa¹² performed both physical activity program and cognitive activity for 30 minutes per session, three times a week for 8 weeks in the case of the experimental group, and only cognitive activity for the same time schedule in the case of the comparison group. The result was that cognitive ability of the experimental group was significantly enhanced compared to that of the comparison group. This part of the result is consistent with ours of cognitive ability after 12 week-psychomotor program. Also, it indicates that the applied number of sessions during the progress of the program is also a critical factor as the duration of the program, considering that the identical conclusions were drawn even the research period of the previous study was shorter than that of our research.

 

4. CONCLUSION:

This study was aimed to help the elderly live a healthy life and provide basic evidence for establishing a psychomotor program for the elderly by demonstrating the effect of the program on elderly women's self-esteem and cognitive ability.

 

The comparison of the results of this research and previous researches led to following conclusions:

As a result from investigating the difference in pre/post-test between the experimental group with application of the psychomotor program and the comparison group with no application of psychomotor program, average value of self-esteem in the experimental group showed significant difference, and the change of cognitive ability in the experimental group was statistically significant. It indicates that application of psychomotor program is effective on enhancement of self-esteem and cognitive ability of the elderly women.

 

This research suggests that the psychomotor program which helps improving self-esteem and sociality is an appropriate program for the elderly women to live a healthy and enjoyable life. Based on the results, this research also can be fundamental evidence for establishing a psychomotor program for the elderly women.

 

The limitation of this study is that it had a limited base of subjects rather than broader groups of people with different social, economic and regional backgrounds and that access to different social activities of the elderly women who participated in the study was not completely controlled.

 

Further studies need a longer span of the psychomotor program and a broader base of subjects. Different types of psychomotor programs for elderly women need to be designed as well. In addition, a standardized test tool is needed to measure the level of self-esteem that changes with ageing of comparison group.

 

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