The Effect of Nursing Intervention Based on the Salutogenic Model on Sense of Coherence, Healthy Aging, and Quality of Life

The world population is rapidly aging, and Turkey is one of the countries where aging is occurring quickly. When the investigators examine the proportion of the elderly population to the total population over the years and decades, the investigators observe that the percentage was 3.9% in 1935, 3.4% in 1955, 4.1% in 1975, 5.7% in 2000, 7.2% in 2010, 7.7% in 2013, and 8.5% in 2017. Finally, in 2022, this proportion reached 9.9%. According to population projections, the proportion of the elderly population is expected to be 12.9% in 2030, 16.3% in 2040, 22.6% in 2060, and 25.6% in 2080 (TUIK, 2022). The increase in the elderly population brings about various health, economic, social, and environmental challenges. In order to address these issues, societies are not only developing care and treatment methods for the elderly but are also giving importance to prevention methods. The ability to live independently is essential for healthy aging and maintaining a healthy population. To support the elderly in living independently, both preventive and therapeutic methods are used. This is because, alongside long life, the quality of life is also of great importance (Gürer et al., 2019). From the perspective of the National Action Plan on Aging, health problems emerge or existing issues are exacerbated with aging, thereby affecting living standards. In addition to the physical changes seen in this period, health problems related to chronic diseases also negatively impact the quality of life.

The increase in life expectancy at birth has contributed to the global increase in the elderly population (onikinciplan.sbb.gov.tr). The ability of elderly individuals to live independently is influenced by their social and economic conditions, physical health, as well as sociodemographic characteristics such as age and gender. The interaction of elderly individuals with society influences their healthy living behaviors. Furthermore, their interaction with personal and societal resources affects their sense of wholeness and quality of life. To achieve a good quality of life, elderly individuals need to use both internal and external resources, and education should support this (Tan et al., 2014). For health services to be effective, they must be sensitive to the differences, experiences, socioeconomic status, and cultural background of individuals. Therefore, health professionals, including nurses, should prioritize providing appropriate health services for elderly individuals during care (Temel et al., 2009). The roles of public health nurses in elderly health include providing education to elderly individuals and caregivers, offering counseling, protecting the health of elderly individuals, conducting physical assessments, teaching self-care and personal hygiene, making home visits when necessary, assessing and taking precautions regarding situations that could cause accidents, evaluating acute health problems and chronic diseases, educating about the management of chronic diseases, and implementing interventions based on nursing diagnoses (Akdemir et al., 2009). The most important principle in ensuring elderly individuals maintain their health and age healthily is to support them in acquiring basic living skills and independence as much as possible. These basic skills, also known as daily living activities, are crucial for preserving the quality of life by enabling elderly individuals to live independently. A review of the literature reveals that there is no evidence of educational or intervention programs aimed at supporting healthy aging for individuals aged 65 and over in Turkey, or programs that focus on holistic health. Therefore, this randomized controlled study will investigate

• Page 2 of 5 [DRAFT] - how an intervention and education program based on the salutogenic model affects elderly individuals' self-efficacy, healthy living behaviors, and coping skills with diseases and stressors. As a result, the applied intervention program will positively impact the quality of life, sense of wholeness, and healthy aging processes of elderly individuals by examining their responses to stressors and revealing the internal and external resources they can utilize. Research Hypotheses Hypothesis 1. H1: There is a difference in the average quality of life scores between elderly individuals in the intervention and control groups. Hypothesis 2. H1: There is a difference in the average sense of wholeness scores between elderly individuals in the intervention and control groups. Hypothesis 2a. H1: There is a difference in the average comprehensibility subscale scores of the sense of wholeness between elderly individuals in the intervention and control groups. Hypothesis 2b. H1: There is a difference in the average meaningfulness subscale scores of the sense of wholeness between elderly individuals in the intervention and control groups. Hypothesis 2c. H1: There is a difference in th