Older people in Sweden with various degrees of present quality of life: their health, social support, everyday activities and sense of coherence
Gunilla Borglin RN MSc PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorUlf Jakobsson RN PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorAnna-Karin Edberg RNT PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorIngalill Rahm Hallberg RNT PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
The Vårdal Institute, The Swedish Institute for Health Sciences, Lund University, PO Box 187, SE-221 00 Lund, Sweden
Search for more papers by this authorGunilla Borglin RN MSc PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorUlf Jakobsson RN PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorAnna-Karin Edberg RNT PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
Search for more papers by this authorIngalill Rahm Hallberg RNT PhD
Department of Health Sciences, Faculty of Medicine, Lund University PO Box 157, SE-221 00 Lund, Sweden and
The Vårdal Institute, The Swedish Institute for Health Sciences, Lund University, PO Box 187, SE-221 00 Lund, Sweden
Search for more papers by this authorAbstract
Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly ‘healthy’ older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with ‘present QoL’ as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with ‘poor or bad’ self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more ‘excellent or good’ self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of ‘poor or bad’ self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
References
- Altman D.G. (1997) Practical Statistics for Medical Research. Chapman & Hall, London.
- Antonovsky A. (1987) Unravelling the Mystery of Health. Jossey-Bass, San Francisco, CA.
- Antonovsky A. (1993) The structure and properties of the sense of coherence scale. Social Science Medicine. 36 (6), 725–733.
- Antonovsky A. (1996) The sense of coherence: an historical and future perspective. Israeli Journal of Medicine Science 32, 170–178.
- Avlund K., Lund R., Holstein B.E. & Due P. (2004) Social relations as determinants of onset of disability in aging. Archives of Gerontology and Geriatrics 38, 85–99.
- Baltes P.B. & Baltes M.M. (1993) Successful Aging: Perspectives from the Behavioural Sciences. Cambridge University Press, Cambridge, UK.
- Beckstead J.W. (2002) Using hierarchical cluster analysis in nursing research. Western Journal of Nursing Research 24 (3), 307–319.
- Bond J., Briggs R. & Coleman P. (1998) The study of ageing. In: J. Bond, P. Coleman & S. Peace (Eds) Ageing in Society: An Introduction to Social Gerontology, 2nd edn, pp. 19–40. Sage Publications, London.
- Borglin G., Jakobsson U., Edberg A.-K. & Hallberg I.R. (2005) Self-reported health complaints and their prediction of overall and health-related quality of life among elderly people. International Journal of Nursing Studies. 42 (2), 147–158.
- Bowling A. (1995) What things are important in people's lives? A survey of the public's judgements to inform scales of health related quality of life. Social Science and Medicine 41 (10), 1447–1462.
- Bowling A., Fleissig A., Gabriel Z., et al. (2003) Let's ask them: a national survey of definitions of quality of life and its enhancement among people aged 65 and over. International Journal of Aging and Human Development 56, 269–306.
- Brayne C., Matthews F.E., McGee M. & Jagger C. (2001) Health and ill-health in the older population in England and Wales. The Medical Research Council Cognitive Function and Ageing Study (MRC CFAS). Age and Ageing 30, 53–62.
- Brown K., Boot D., Groom L. & Williams E.I. (1997) Problems found in the over-75s by the annual health check. British Journal of General Practice 47, 31–35.
- Browne J.P., O'Boyle C.A., McGee H.M., Joyce C.R.B., McDonald N.J., Malley K.O. & Hiltbrunner B. (1994) Individual quality of life in the healthy elderly. Quality of Life Research 3, 235–244.
- Bryant L.L., Beck A. & Fairclough D.L. (2000) Factors that contribute to positive perceived health in an older population. Journal of Aging and Health 12 (2), 169–192.
- Byles J.E. (2000) A thorough going over: evidence for health assessments for older persons. Australian and New Zealand Journal of Public Health 24 (2), 117–124.
-
Cronbach L.J. (1951) Coefficient alpha and the internal structures of tests.
Psychometrika
3, 297–334.
10.1007/BF02310555 Google Scholar
- Dempster M. & Donnelly M. (2000) How well do elderly people complete individualised quality of life measures: an exploratory study. Quality of Life Research 9, 369–375.
- Elkan R., Kendrick D., Dewey M., et al. (2001) Effectiveness of home based support for older people: systematic review and meta-analysis. British Medical Journal 323, 1–9.
- Farquhar M. & Bowling A. (1993) Functional ability of very elderly people. Nursing Standard 8 (7), 31–36.
- Faulkner M. & Davies S. (2005) Social support in the healthcare setting: the role of volunteers. Health and Social Care in the Community 13 (1), 38–45.
- Fok S.K., Chair S.Y. & Lopez V. (2003) Sense of coherence, coping and quality of life following a critical illness. Journal of Advanced Nursing 49 (2), 173–181.
- Fone S. & Lundgren-Lindqvist B. (2003) Health status and functional capacity in a group of successfully ageing 65–85-year-olds. Disability and Rehabilitation 25 (18), 1044–1051.
- Fries J.F. (2002) Successful aging – an emerging paradigm of gerontology. Clinics in Geriatric Medicine 18, 371–382.
- Godfrey M. (2001) Prevention: developing a framework for conceptualizing and evaluating outcomes of preventive services for older people. Health and Social Care in the Community 9 (2), 89–99.
- van Haastregt J.C., Diederiks J.P., van Rossum E., de Witte L.P. & Crebolder H.F. (2000) Effects of preventive home visits to elderly people living in the community: systematic review. British Journal of Medicine 320, 754–758.
- Hagberg M., Hagberg B. & Saveman B.-I. (2002) The significance of personality factors for various dimensions of life quality among older people. Aging and Mental Health 6 (2), 178–185.
- Hair J.F., Anderson R.E., Tatham R.L. & Black W.C. (1998) Multivariate Data Analysis, 5th edn. Prentice Hall, Upper Saddle River, New Jersey.
- Holmes S. (2005) Assessing quality of life: reality or impossible dream? International Journal of Nursing Studies 42, 493–501.
-
Idler E.L. &
Kasl S.V. (1995) Self-ratings in health: do they also predict change in functional ability?
Journal of Gerontology: Social Sciences
50B (6), 344–353.
10.1093/geronb/50B.6.S344 Google Scholar
- Kazdin A.E. (1998) Research Design in Clinical Psychology, 3rd edn. Allyn & Bacon, Boston, MA.
- Lagergren M. (2002) The system of care for frail elderly persons: the case of Sweden. Aging Clinical and Experimental Research 14 (4), 252–257.
- Lawton M.P. (1975) The Philadelphia geriatric center morale scale: a revision. Journal of Gerontology 30 (1), 85–89.
- Neugarten B.L., Havighurst R.J. & Tobin S.S. (1961) The measurement of life satisfaction. Journal of Gerontology 16, 134–143.
- Nilsson B., Holmgren L., Stegmyr B. & Westman G. (2003) Sense of coherence – stability over time and relation to health, diseases, and psychosocial changes in a general population: a longitudinal study. Scandinavian Journal of Public Health 31, 297–304.
- Nordbeck B., Hagberg B., Jadbäck G. & Johansson B. (1992) Stroke patients in Sweden. In: XV World Congress of Gerontology. Budapest, Hungary.
- Palos G.R., Mendoza T.R., Cantor S.B., Aday L.A. & Cleeland C.S. (2004) Perceptions of analgesic use and side effects: what the public values in pain management. Journal of Pain and Symptom Management 28 (5), 460–473.
- Pinquart M. & Sörensen S. (2001) Gender differences in self-concept and psychological well-being in old age: a meta-analysis. Journal of Gerontology: Psychological Sciences 56, 195–213.
- Raphael D., Brown I., Renwick R., Cava M., Weir N. & Heatcote K. (1997) Measuring the quality of life of older persons: a model with implications for community and public health nursing. International Journal of Nursing Studies 34, 231–239.
- Rowe J.W. & Kahn R.L. (1998) Successful Aging: The Macarthur Foundation Study, 36–52. Dell Publishing, New York.
- Rubenowitz S. (1980) Method Development for Mapping Psychosocial Factors to Consider with Regional Development Planning. Rapport nr. 3. Psykologiska Institutionen. Göteborgs Universitet. [In Swedish].
- Smith J. & Baltes M.M. (1998) The role of gender in very old age: profiles of functioning and everyday life patterns. Psychology and Aging 13 (4), 676–695.
- SPSS Inc. (2003) SPSS for Windows statistical software, Release 12.0.1. 2. Chicago, Illinois.
- Stenzelius K., Mattiasson A., Rahm Hallberg I.L. & Westergren A. (2004) Symptoms of urinary and faecal incontinence among men and women 75+ in relation to health complaints and quality of life. Neurourology and Urodynamics 23, 211–222.
- Stenzelius K., Westergren A., Thorneman G. & Hallberg I.L. (2005) Patterns of health complaints among people 75+ in relation to quality of life and need of help. Archives of Gerontology and Geriatrics 40 (1), 85–102.
- Stuck A.E., Minder C.E., Peter-Wuest I., et al. (2000) A randomised trial of in-home visits for disability prevention in community dwelling older people at low and high risk for nursing home admission. Archives of International Medicine 160, 977–986.
- Sullivan M., Karlsson J. & Taft C. (1997) SF-12 Health Questionnaire. Swedish Manual. Sektionen för vårdforskning, Medicinska Fakulteten. Göteborgs Universitet. Göteborg. [In Swedish].
-
Underhill Motzer S. &
Stewart B.J. (1996) Sense of coherence as a predictor of quality of life in persons with coronary heart disease surviving cardiac arrest.
Research in Nursing and Health
19, 287–298.
10.1002/(SICI)1098-240X(199608)19:4<287::AID-NUR3>3.0.CO;2-E CAS PubMed Web of Science® Google Scholar
- Vass M., Avlund K., Kvist K., Hendriksen C., Andersen C.K. & Keiding N. (2004) Structured home visits to older people: are they only of benefit for woman? A randomised controlled trial. Scandinavian Journal of Primary Health Care 22, 106–111.
- Vernon S., Ross F. & Gould M.A. (2000) Assessment of older people: politics and practice in primary care. Journal of Advanced Nursing 31, 282–287.
- Ware J.E. & Sherbourne C.D. (1992) The MOS 36-item short-form health survey (SF-36) conceptual framework and item selection. Medical Care 30 (6), 473–481.
- Wenger C. (1991) A network typology: From theory to practice. Journal of Aging Studies 5 (2), 147–162.