Background: The concept of Functional Independence (FI), defined as ‘functioning physically safe and independent from other persons, within one’s context”, plays an important role in maintaining the functional ability to enable well-being in older age. FI is a dynamic and complex concept covering four clinical outcomes: physical capacity, empowerment, coping flexibility, and health literacy. As the level of FI differs widely between older adults, healthcare professionals must gain insight into how to best support older people in maintaining their level of FI in a personalized manner. Insight into subgroups of FI could be a first step in providing personalized support This study aims to identify clinically relevant, distinct subgroups of FI in Dutch community-dwelling older people and subsequently describe them according to individual characteristics. Results: One hundred fifty-three community-dwelling older persons were included for participation. Cluster analysis identified four distinctive clusters: (1) Performers – Well-informed; this subgroup is physically strong, well-informed and educated, independent, non-falling, with limited reflective coping style. (2) Performers – Achievers: physically strong people with a limited coping style and health literacy level. (3) The reliant- Good Coper representing physically somewhat limited people with sufficient coping styles who receive professional help. (4) The reliant – Receivers: physically limited people with insufficient coping styles who receive professional help. These subgroups showed significant differences in demographic characteristics and clinical FI outcomes. Conclusions: Community-dwelling older persons can be allocated to four distinct and clinically relevant subgroups based on their level of FI. This subgrouping provides insight into the complex holistic concept of FI by pointing out for each subgroup which FI domain is affected. This way, it helps to better target interventions to prevent the decline of FI in the community-dwelling older population.
Purpose: The purpose of this paper is to report the grounded theory empirical validation on key categories within a design-led methodology to envision urban futures. The paper focuses on the editorial products and the design concepts that constitute the heart of the approach. An original elaboration of trend clusters is presented as an exemplification of the outcome of this trend research approach. Although the approach was not created from the viewpoint of tourism and leisure, bibliographic notes on place-making complement it for this journal. Design/methodology/approach: The paper presents empirical findings extracted by the means of the grounded theory, with the purpose to empirically validate two key categories (product and process) of a urban futures methodology. The methodology is an application of High Design, the process in use at Royal Philips BV for two decades. This methodology is contextualized within the constructivist episteme, as defined by the editors of this journal in a separate publication. Bibliographic references to place-making complete the paper. Findings: The following findings are provided: empirical validation of the city.people.light communication platform (qualitative research); empirical validation of the city.people.light workshop practice (qualitative research); and bibliographic descriptions of the design process governing city.people.light and newly developed urban futures trend clusters, at European level, as an exemplification of the program/approach outcome. Research limitations/implications: The paper is structured according to a multi-layered editorial focus. Empirical findings were generated at primary research level in a 2013-2015 grounded theory projected by the author. Furthermore, the author directed the research processes and products that are the object of empirical validation. Newly defined elaborations and a discussion thereof is offered, taking into account contemporary place-making issues. Practical implications: The original design-based methodology is a structured practice in urban futures from applied sciences and corporate innovation viewpoint. In this paper, its key categories are empirically validated through the grounded theory. Additionally, outcome from the original foresight programs is presented and a bibliographic review is provided from the viewpoint of place-making. Social implications: The co-creative methodology herein empirically validated is socio-cultural centered, with a strong drive to coutnerbalance the positivist and engineering corporate mindset through a humanistic concern for people. The framework in terms of place-making takes into account postmodern evolutions of the field. Originality/value: The paper benefits from a unique mix of: epistemic note on tourism, leisure, and the future; original urban futures scenarios and design concepts from a world class corporate innovation program; and the actual empirical core of the grounded theory validation as performed in a dedicated research project. These three separate streams are mutually related.
