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Author ORCID Identifier



Open Access Dissertation

Document Type


Degree Name

Doctor of Philosophy (PhD)

Degree Program


Year Degree Awarded


Month Degree Awarded


First Advisor

Cynthia Jacelon

Second Advisor

Jeungok Choi

Third Advisor

Daniel Gerber

Subject Categories

Social and Behavioral Sciences


Supporting older adult clients to improve self-management of health is a focus of care for community-based nurses working with this population. The available literature on small group work indicates participation in a variety of group types has been shown to be beneficial for older adults. However, there is little research specifically on group work with adults over the age of 75 when individuals are at greater risk for actively facing illness and multiple personal losses and may need enhanced social supports to assist achievement of the psychosocial tasks of old age. This research examined a support and learning group on aging and health involving seven community-dwelling older adults over the age of 75 using grounded theory research method. One male and six female subjects aged 76-84 years old participated in the study. To identify themes occurring in group and communication process, transcripts of the meetings, pre and post interviews with individual participants, and other data sources were analyzed using open, axial and selective coding. On the Group Process level, themes of group action/interaction were categorized by time phases of Before, Beginning, Middle, End, and Beyond the time the group met. On the Communication Process level, themes were abstracted under categories of Initiating, Responding, Relating, and Integrating. Group and Communication processes were then nested and conceptualized as a fractal occurring both over the course of the eight weeks and in every group meeting. “Relating” was identified as a core phenomenon of the group and communication process, contributing to positive self-assessment regardless of whether the participant affirmed a similar or contrasting position in comparison with other participants. Findings support the achievement of group type objectives for support and learning groups and delineate more clearly group participants’ experience leading to the outcomes of reinforcement of a positive self-assessment and the development of knowledge and skills related to aging and health. Findings may assist the design and implementation of similar groups and may direct further research on specific aspects of individual and group process in small group work with community-dwelling older adults.