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The aging process is considered not only as a phase characterized by changes in physical functioning, but also as a multidimensional life stage affecting psychosocial well-being, social participation, and quality of life. The World Health Organization's healthy aging approach and the International Classification of Functioning, Disability and Health emphasize that the health status of older adults should be evaluated through the interaction of biological, psychological, and social dimensions. The literature indicates that physical activity and rehabilitation-based interventions not only improve functionality in older individuals but also enhance psychological well-being and social participation; however, the sustainability of these gains is largely determined by social support and environmental factors. In this context, the integration of social work and physiotherapy practices has gained importance in terms of interdisciplinary and holistic intervention models in elderly care.
The aim of this study is to comparatively examine the effects of a social work-supported physiotherapy intervention, implemented among students enrolled in a Third Age University (60+ Refresher University) and older adults living in a nursing home in Turkey, on functionality, psychosocial well-being, and social health levels within the ICF framework. The study is designed as a pretest-posttest controlled quasi-experimental research model. The study population consists of students of Munzur 60+ Refresher University and individuals aged 60 and over residing in a nursing home in Tunceli. Participants selected through stratified random sampling will be assigned to intervention and control groups. A 6-week social work-supported physiotherapy program will be implemented for the intervention groups by physiotherapists and social workers. During the data collection process, physical functioning, psychosocial well-being, and social health-covering the components of the ICF-will be assessed before and after the intervention using standardized measurement tools. The study is expected to provide evidence-based contributions to holistic and interdisciplinary intervention models for older adults.
The aging process is a multidimensional life stage that leads to significant changes not only in individuals' physical functioning but also in their psychosocial well-being, social participation, and social roles. The World Health Organization defines healthy aging as the ability of individuals to maintain functional capacity and lead a meaningful life in later stages of life, emphasizing that this process is shaped by the interaction of biological, psychological, and social components. This perspective highlights that interventions targeting older adults should not be limited to disease and physical decline, but should instead adopt a holistic approach encompassing daily life, social relationships, and social participation.
The International Classification of Functioning, Disability and Health, developed by the World Health Organization, provides a comprehensive framework that conceptualizes health not only in terms of diagnoses and impairments, but also through body functions and structures, activities, participation, and environmental factors. The ICF facilitates a better understanding of the relationships between physical functioning, social participation, life satisfaction, and psychosocial well-being, particularly among older adults, and offers a common conceptual language for rehabilitation and social work fields. The ICF enables an interdisciplinary evaluation of health and functioning.
The literature indicates that physical activity and rehabilitation-based interventions improve balance, mobility, and functional capacity in older adults, while also being associated with reductions in depressive symptoms, enhanced psychological well-being, and improved quality of life. The physical activity is a key protective factor not only for physiological health but also for psychological and social well-being. Similarly, participation in regular physical activity has been shown to positively influence self-efficacy, emotional well-being, and social interaction among older adults.
However, recent studies suggest that the sustainability of gains in physical functioning is strongly influenced by social support, motivation, and environmental opportunities. The social support and psychosocial factors play a central role in older adults' participation in physical activity. In this context, social work emerges as a complementary profession that facilitates access to environmental resources, strengthens social relationships, and supports psychosocial well-being.
The social context in which older individuals live has a decisive impact on their psychosocial well-being and social health. Older adults living in nursing homes often represent a more vulnerable group due to social isolation, role loss, and the constraints of institutional living. In contrast, Third Age Universities, which emphasize lifelong learning and social participation, provide protective environments that support active aging. The literature clearly demonstrates that different living arrangements lead to significant differences in mental health and life satisfaction among older adults.
The WHO's Integrated Care for Older People (ICOPE) approach also emphasizes that services for older adults should be structured in a person-centered, interdisciplinary, and function-oriented manner. ICOPE recommends addressing physical capacity alongside psychological and social dimensions simultaneously, demonstrating strong conceptual alignment with the ICF model. Within this framework, social work-supported physiotherapy interventions are considered to offer a holistic approach that can contribute not only to physical functioning but also to psychosocial well-being and social health among older individuals.
This study has the potential to provide an original and interdisciplinary contribution to holistic health approaches in the field of aging within the Turkish context. Despite international policy documents emphasizing the importance of supporting not only physical functioning but also psychosocial well-being and social health in older adults, comparative intervention studies integrating social work and physiotherapy within an ICF-based framework remain limited. This study addresses this gap by examining both community-based active aging models, such as Third Age Universities, and institutional care settings, such as nursing homes, thereby revealing how older individuals respond to interventions across different social contexts. It is expected that the findings will generate evidence on the effectiveness of interdisciplinary intervention models and provide a scientific basis for developing policies and practices in Turkey that holistically address functionality, participation, and psychosocial support in services for older adults. Furthermore, the results are anticipated to contribute to the integration of the ICF framework into social work practice and to inform the development of innovative, applicable, and sustainable intervention models in the field of elderly welfare.
The aim of this study is to comparatively examine the effects of a social work-supported physiotherapy intervention on functionality levels, psychosocial well-being, and social health-within the framework of the International Classification of Functioning, Disability and Health (ICF)-among students enrolled in the 60+ Refresher University (Third Age University model) and older adults living in nursing homes in Turkey. Accordingly, the study seeks to compare the psychosocial and social outcomes of physiotherapy interventions centered on physical functioning when integrated with social work interventions across different institutional and social contexts, namely a lifelong learning-based Third Age University model and an institutional care setting.
Research Hypotheses Hypothesis 1: ICF-Based Functionality H0₁ (Null Hypothesis): There is no significant change in participants' ICF-based functionality levels after the social work-supported physiotherapy intervention compared to pre-intervention levels.
H1₁ (Alternative Hypothesis): There is a significant improvement in participants' ICF-based functionality levels after the social work-supported physiotherapy intervention compared to pre-intervention levels.
Hypothesis 2: Psychosocial Well-Being H0₂ (Null Hypothesis): There is no significant change in participants' psychosocial well-being levels after the intervention compared to pre-test measurements.
H1₂ (Alternative Hypothesis): There is a significant increase in participants' psychosocial well-being levels after the intervention compared to pre-test measurements.
Hypothesis 3: Social Health H0₃ (Null Hypothesis): There is no significant change in participants' social health levels after the intervention compared to pre-test measurements.
H1₃ (Alternative Hypothesis): There is a significant increase in participants' social health levels after the intervention compared to pre-test measurements.
Hypothesis 4: Between-Group Comparison H0₄ (Null Hypothesis): There is no significant difference between Third Age University students and nursing home residents in terms of the effects of the intervention on functionality, psychosocial well-being, and social health.
H1₄ (Alternative Hypothesis): There is a significant difference between Third Age University students and nursing home residents in terms of the effects of the intervention on functionality, psychosocial well-being, and social health.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Refresher Group Training | Experimental |
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| Nursing Home Training | Experimental |
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| Control Group | No Intervention |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Social Work-Supported Physiotherapy | Other | Refresher University Group A social work-supported physiotherapy intervention will be implemented face-to-face for six weeks by physiotherapists and social workers at Munzur University's 60+ Refresher University. |
| Measure | Description | Time Frame |
|---|---|---|
| Demographic and Clinical Characteristics: | Participants' demographic data, and presenting complaints at admission, diagnoses, medications used, history of surgical procedures, and comorbid conditions will be assessed. | From enrollment to the end of the 6-week training period |
| Fatigue Severity Scale (FSS) | Fatigue will be assessed using the Fatigue Severity Scale. Participants will respond to the items by rating them on a scale from 1 to 7. The scale consists of nine items, each scored between 1 and 7. Lower scores indicate lower levels of fatigue. | From enrollment to the end of the 6-week training period |
| 6-Minute Walk Test (6MWT) | The 6-Minute Walk Test is a standardized performance-based measure used to evaluate functional exercise capacity. It assesses the distance an individual can walk on a flat surface within six minutes. The test reflects submaximal aerobic capacity and is widely used in clinical and rehabilitation settings. A greater distance indicates better functional capacity. | From enrollment to the end of the 6-week training period |
| International Physical Activity Questionnaire | The International Physical Activity Questionnaire is a widely used self-report tool that assesses the frequency, duration, and intensity of physical activity across different domains (e.g., work, transportation, leisure). It provides estimates of total physical activity levels. A higher total score indicates a higher level of physical activity. | From enrollment to the end of the 6-week training period |
| Multidimensional Quality of Life Scale | The Multidimensional Quality of Life Scale evaluates individuals' perceived quality of life across multiple domains, including physical, psychological, and social well-being. It provides a comprehensive assessment of overall life satisfaction and functioning. Higher scores indicate a better quality of life. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hakan C Assist Prof. Dr., Phd | Contact | +905500758127 | shuhakan.coskun@hotmail.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tunceli | Tunceli | Tunceli | 62000 | Turkey (Türkiye) |
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Non-randomised controlled study
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Individuals are not aware of the content and benefits of the treatment to be implemented.
| From enrollment to the end of the 6-week training period |
| Revised Community Participation Questionnaire | The Revised Community Participation Questionnaire is used to assess individuals' level of participation in social, community, and daily life activities. It evaluates the frequency and diversity of participation, as well as perceived barriers and facilitators to engagement. Higher scores indicate a greater level of participation. | From enrollment to the end of the 6-week training period |
| Depression Anxiety Stress Scale | The Depression Anxiety Stress Scale is a self-report instrument designed to measure negative emotional states across three dimensions: depression, anxiety, and stress. It consists of multiple items rated on a Likert scale, providing separate subscale scores for each domain. Higher scores indicate greater levels of depression, anxiety, and stress (i.e., more severe negative emotional states). | From enrollment to the end of the 6-week training period |
| Physical Activity Barriers Scale | The Physical Activity Barriers Scale assesses perceived obstacles that limit individuals' participation in physical activity. These barriers may include physical, psychological, environmental, and social factors that influence engagement in exercise. Higher scores indicate greater perceived barriers to physical activity. | From enrollment to the end of the 6-week training period |
| Psychological Well-Being Scale for Older Adults | This scale measures the psychological well-being of older individuals, including dimensions such as autonomy, purpose in life, emotional balance, and personal growth. It provides insight into the subjective mental health status of elderly populations. Higher scores indicate better psychological well-being. | From enrollment to the end of the 6-week training period |
| Social Health Scale for Older Adults | The Social Health Scale for Older Adults evaluates social functioning, including interpersonal relationships, social roles, social support, and community integration. It reflects the social dimension of health and well-being in later life. Higher scores indicate better social health and functioning. | From enrollment to the end of the 6-week training period |