Older people in Sweden with various degrees of present quality of life: their health, social support, everyday activities and sense of coherence

Depression and anxiety in patients with chronic renal failure: the effect of sociodemographic characteristics

"Do the sociodemographic characteristics relate to the levels of depression and anxiety in patients with chronic renal failure in Athens?" The study investigated in a group of renal disease patients differences referring to self-reported mental health, depression, and anxiety, after controlling for gender, age, education, and marital status. Patient-reported assessments included General Health Questionnaire (GHQ-28) of Goldberg, Center for Epidemiological Studies Depression Scale (CES-D), and State-Trait Anxiety Inventory (STAI I & II) of Spielberger. Female patients reported higher scores in the trait anxiety measure. Elder patients reported higher scores in the GHQ-28 subscale of social dysfunction and in the CES-D depression scale, while less educated patients presented higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression. Divorced/widowed patients presented higher scores in the severe depression subscale. Findings provide evidence that sociodemographic variables, like being older, less educated, and divorced/widowed, relate to a more compromised mental health.

Health and well-being profiles of older European adults

The purpose of the present study was to identify health and well-being typologies among a sample of older European adults. Further, we examined various demographic, social, and health behaviour characteristics that were used to discriminate between such groups. The participants were 1,381 community-dwelling adults aged 65 years and above (M age = 73.65; SD = 7.77) from six European Union (EU) countries who completed self-reported questionnaires. Hierarchical cluster analysis was initially conducted followed by a k means analysis to confirm cluster membership. Four clusters were identified and validated: 'good health and moderate functioning' (38.40%), 'moderate health and functioning' (30.84%), 'obese and depressed' (20.24%) and 'low health and functioning' (10.51%). The groups could be discriminated based on age, gender, nationality, years of education, social isolation and health behaviours (alcohol consumption and walking behaviour). The results of the study demonstrate heterogeneity with regard to the relationships between the variables examined. The information can be used in targeting older Europeans for health promotion interventions.

Social Support Networks and Expectations for Aging in Place and Moving

This study investigated the relationship of social support networks with expectations for aging in place and moving in a sample of relatively healthy, community-dwelling adults ( N = 4,611). Results indicated that those with aging in place expectation and those with moving expectation were comparable in sociodemographics, self-rated health, and social support networks. Knowledge of home- and community-based services (HCBS) availability was associated with respondents reporting an older age at which they expected regular help and moving. When compared with those who did not offer an age prediction, knowledge of HCBS availability, information sources for personal care, and social activity engagement were important in understanding the choices of age ranges at which respondents expected to age in place and to move. Findings point to the importance of expanding social support networks, providing opportunities for social activity, and strengthening information networks with the emphasis on targeting older adults and their caregivers.

Healthy ageing in a salutogenic way: building the HP 2.0 framework

Healthy ageing is influenced by a variety of interacting determinants. Because no one agency can tackle all these determinants, the promotion of healthy ageing requires an intersectoral approach. The aim of this article is to describe a theoretical basis, the development and possible applications of a framework within a municipality in the Netherlands. This framework supports intersectoral collaboration by guiding and stimulating the development, implementation and evaluation of health promotion activities for healthy ageing. It is based on the principles of health promotion and on the theory of salutogenesis and built upon three interrelated central concepts: (1) sense of coherence, (2) resources for health, and (3) health. The framework visualises the interrelationships of the three concepts within health promotion and salutogenesis. This visualisation makes explicit the value and the contribution with respect to content of intersectoral collaboration and the participation of older people in health promotion. The relationships between the concepts of the framework also indicate the need to undertake different types of research and gather different kinds of data to develop, implement and evaluate healthy ageing strategies.

Motivation to physical activity among adults with high risk of type 2 diabetes who participated in the Oulu substudy of the Finnish Diabetes Prevention Study

Type 2 diabetes can be prevented by lifestyle changes such as sufficient level of physical activity. The number of persons at high risk of or diagnosed with type 2 diabetes is increasing all over the world. In order to prevent type 2 diabetes and develop exercise counselling, more studies on motivators and barriers to physical activity are needed. Thus, the aim of this qualitative study was to describe the motivators and barriers to physical activity among individuals with high risk of type 2 diabetes who participated in a substudy of the Finnish Diabetes Prevention Study in Oulu and to consider whether the motivators or barriers changed during the follow-up from 2003 to 2008. Questionnaires with open-ended questions were conducted twice: in the first follow-up in 2003 altogether 63 participants answered the questionnaire (n = 93), and in the second follow-up in 2008 altogether 71 participants answered the questionnaire (n = 82). Thus, response rate was 68% in 2003 and 87% in 2008. The study was conducted in the city of Oulu in Finland. Qualitative data were analysed by inductive content analysis using the QSR NVivo 8 software. The results of this study showed that motivators to physical activity included weight management, feelings of physical and mental well being. In addition, social relationships associated with exercise were also motivators. In conclusion, we present that regular counselling is important in order to promote exercise among older people, and that motivators to exercise are strengthened by positive experiences of exercise as one grows older.

Factors related to perceived life satisfaction among the elderly in South Korea

OBJECTIVES

This study attempted to explore the aging phenomena that now characterize much of Korean society, and assessed issues associated with the life satisfaction experienced during the process of aging.

METHODS

By employing the National Survey on the State of Life and the Desire for Welfare of the Elderly, 2004 in South Korea this study attempted to identify the factors that determine subjective life satisfaction among the elderly. The data utilized herein consisted of 3278 elderly people aged 65 years or older, from 9308 households.

RESULTS

The results of analysis from the final model after the introduction of 19 variables in 8 factors showed statistically similar explanatory power in men (adj. R²=0.320) and in women (adj. R²=0.346). We found that economic condition was the most influential factor in both men (B=0.278) and women (B=0.336) except perceived health condition variables. The second most influential variable in life satisfaction was health checkups in men (B=0.128) and degree of nutritional diet in women (B=0.145). Those who had experience with chronic diseases also reported significantly lower perceived life satisfaction and this was particularly true of women.

CONCLUSIONS

The aging society requires an understanding of the lives of elderly individuals. This study explored factors associated with life satisfaction in old age by using a life satisfaction model. The success of an aging society begins with an accurate understanding of the elderly, and thus political attention will need to be focused on this matter.

Quality of life in older Norwegian adults living at home: a cross-sectional survey

The term quality of life (QoL) has been used in nursing for several years despite having neither a common conceptual model nor a common definition. The Wilson and Cleary Model (WCM), defined in 1995, is used as a conceptual model to identify suitable variables important in planning nursing care in a study among Norwegian older adults. The objective of this study was to investigate how the relationships among depressive symptoms, physical function, health satisfaction, age and environment may predict QoL in a model based on the WCM. The overall model provides empirical evidence for linkages in the WCM. Results showed that QoL is likely to be influenced by the direct effects of environmental conditions, health satisfaction and age. In addition, environmental conditions and age had indirect effects on QoL, in particular via depressive symptoms. Environment had both a significant direct and an indirect effect on QoL. An indirect effect of environment on QoL was shown with depressive symptoms, physical function and perceived health as mediators. There was only a small amount of evidence for age predicting QoL. This model may help nurses and other health care workers to collect and assess information, to suggest suitable interventions and to guide decision making.

Sense of coherence and health among home-dwelling older people

Sense of coherence (SOC) is important for maintaining health. The aim of this study was to investigate if the SOC experience among home-dwelling physically active older people differs from that of hospital patients with the same age and sex. Data were collected with questionnaires and structured interviews containing Antonovsky's SOC scale in an age- and sex-matched study group (n=160). Non-parametric statistical analyses were performed. No differences were found in SOC between home-dwelling individuals and patients. Ninety-five percent of the home-dwelling individuals perceived themselves as being in good health and 42.5% among the patients (p<0.001). SOC and disease were predictors for health in the total study group. Among the home-dwelling individuals, SOC, disease and being single were predictors for health and among the patients solely SOC. When using the components of the SOC concept, comprehensibility and disease predicted health for the home-dwelling individuals and meaningfulness predicted health for the patients.

Quality of life among Norwegian older adults: focus group results

Fundamental to the nursing profession is understanding what issues are important to quality of life (QoL) for older adults. The aim of this study was to explore issues of importance to older adults and to compare findings with Lawton's theoretical QoL conceptualization. Five focus groups were conducted with healthy and hospitalized adults and health professionals. Many valued aspects of human existence were found to affect QoL, and results lend empirical support to many of the themes appearing under Lawton's four sectors. Results indicate the need for multidimensional assessments of QoL among older adults related to health, psychological, personal competency, social, environmental, and spiritual indicators. Issues related to time use, happiness, cognitive functioning, self-concept, coping with change, social functioning, self-determination, altruistic activity, living conditions, security, and technological aids should also be considered in future assessments of QoL. Research is needed to explore the relevancy of these issues in future assessments of QoL among older adults.

“Not Ready to Throw in the Towel”: Perceptions of Physical Activity Held by Older Adults in Stockholm and Dublin

The aim of this qualitative study was to explore and describe the perceptions of physical activity held by older urban Swedish and Irish adults. Qualitative interviews were carried out with 30 people age 65 years and older (mean age 74.5), of whom 15 were living in Dublin and 15 were living in Stockholm. The “thematic framework” approach was used to analyze the data. Three central themes were identified regarding people’s perceptions of physical activity: physical activity as self-expression, physical activity as interaction, and physical activity as health promotion. Participants’ perceptions of physical activity tended to relate to their perceived level of physical activity, regardless of their cultural background. Certain culture-specific motivators and barriers to exercise were also identified. Less active Irish men were more likely to underestimate the health-promoting benefits of exercise.

Quality of life in Lithuanian population: the impact of country residence and socio-economic status

Quality of life (QoL) and individual perception of health has become a subject of great interest in Lithuania. The relationships between country residence, socio-economic status (SES), and QoL have not been well characterized among the Lithuanian urban and rural populations. The aim of the study was to assess the influence of country residence and SES on QoL in Lithuanian urban and rural population adjusting for the influence of other known determinants of QoL. The study population was randomly selected from 1193 urban and 264 rural men and women aged 45–72 years and have been filled in the self-administered the WHOQOL-100 questionnaire. The survey participation rate was 62.8%. Psychometric evaluation of the WHOQOL-100 showed good internal reliability of Cronbach’s α from 0.78 to 0.94. Multiple linear regression models were used to study the influence of country residence and SES on the WHOQOL-100 scores while adjusting for the influence of other determinants of QoL. After adjusting for the influence of these factors, country residence and SES independently influenced QoL. Rural residence negatively affected the overall QoL, psychological domain, level of independence and spirituality. Higher education level and income directly and positively influenced the WHOQOL-100 scores, while retired, unemployed and residents with chronic medical conditions had negative influence WHOQOL-100 scores. The study results conclude that country residence and SES are associated with differences in QoL among urban and rural Lithuanian population.

Quality of life, mental health and health beliefs in haemodialysis and peritoneal dialysis patients: investigating differences in early and later years of current treatment

BACKGROUND

The study examines differences regarding quality of life (QoL), mental health and illness beliefs between in-centre haemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD/PD) patients. Differences are examined between patients who recently commenced treatment compared to patients on long term treatment.

METHODS

144 End-Stage Renal Disease (ESRD) patients were recruited from three treatment units, of which 135 provided full data on the variables studied. Patients consisted of: a) 77 in-centre haemodialysis (HD) and 58 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, all currently being treated by dialysis for varied length of time. Patients were compared for differences after being grouped into those who recently commenced treatment (< 4 years) and those on long term treatment (> 4 years). Next, cases were selected as to form two equivalent groups of HD and CAPD/PD patients in terms of length of treatment and sociodemographic variables. The groups consisted of: a) 41 in-centre haemodialysis (HD) and b) 48 continuous ambulatory peritoneal dialysis (CAPD/PD) patients, fitting the selection criteria of recent commencement of treatment and similar sociodemographic characteristics. Patient-reported assessments included: WHOQOL-BREF, GHQ-28 and the MHLC, which is a health locus of control inventory.

RESULTS

Differences in mean scores were mainly observed in the HD patients with > 4 years of treatment, providing lower mean scores in the QoL domains of physical health, social relationships and environment, as well as in overall mental health. Differences in CAPD/PD groups, between those in early and those in later years of treatment, were not found to be large and significant. Concerning the analysis on equivalent groups derived from selection of cases, HD patients indicated significantly lower mean scores in the QoL domain of environment and higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression, indicating more symptoms in these areas of mental health. With regards to illness beliefs, HD patients who recently commenced treatment provided higher mean scores in the dimension of internal health locus of control, while CAPD/PD patients on long term treatment indicated higher mean scores in the dimension of chance. Regarding differences in health beliefs between equivalent groups of HD and CAPD/PD patients, HD patients focused more on the dimension of internal health locus of control.

CONCLUSION

The results provide evidence that patients in HD treatment modality, particularly those with many years of treatment, were experiencing a more compromised QoL in comparison to CAPD/PD patients.

Sense of coherence as a resource in relation to health-related quality of life among mentally intact nursing home residents - a questionnaire study

BACKGROUND

Sense of coherence (SOC) is a strong determinant of positive health and successful coping. For older people living in the community or staying in a hospital, SOC has been shown to be associated with health-related quality of life (HRQOL). Studies focusing on this aspect among nursing home (NH) residents have been limited. This study investigated the relationship between SOC and HRQOL among older people living in NHs in Bergen, Norway.

METHODS

Based on the salutogenic theoretical framework, we used a descriptive correlation design using personal interviews. We collected data from 227 mentally intact NH residents for 14 months in 2004-2005. The residents' HRQOL and coping ability were measured using the SF-36 Health Survey and the Sense of Coherence Scale (SOC-13), respectively. We analyzed possible relationships between the SOC-13 variables and SF-36 subdimensions, controlling for age, sex, marital status, education and comorbidity, and investigated interactions between the SOC and demographic variables by using multiple regression.

RESULTS

SOC scores were significantly correlated with all SF-36 subscales: the strongest with mental health (r = 0.61) and the weakest with bodily pain (r = 0.28). These did not change substantially after adjusting for the associations with demographic variables and comorbidity. SOC-13 did not interact significantly with the other covariates.

CONCLUSION

These findings suggest that more coping resources improve HRQOL. This may indicate the importance of strengthening the residents' SOC to improve the perceived HRQOL. Such knowledge may help the international community in developing nursing regimens to improve HRQOL for older people living in NHs.

Determinants of Self-Rated Health Items With Different Points of Reference

Objective: This study assessed whether three commonly used self-rated health (SRH) items (global, age-comparative, and self-comparative) are equivalent measures of health perception for older adults. Method: Regression analyses were used to simultaneously contrast the associations between physical, psychological, and social factors relating to health for three SRH items, in a large ( N = 2,034) population-based sample of older adults (65 years and older) from the Australian Longitudinal Study of Aging. Results: Health perceptions were more positive for the age-comparative SRH measure, compared to the pessimistic ratings of the self-comparative measure, particularly for the oldest-old adults. Different patterns of associations between the health factors and SRH measures were found. Discussion: These results show the three SRH items are not equivalent measures of health and cannot be used interchangeably. The reference point of the SRH item has a considerable influence on health perceptions of older adults as it encapsulates unique health information.

Quality of life of older adults in Canada and Norway: examining the Iowa model

In this study, Glick and Tripp-Reimer's (1996) Iowa model for gerontological nursing serves as a guiding framework for a descriptive exploratory study of quality of life (QOL) of older adults. Using secondary data, the authors explored whether the effects of health appraisal, morbidities, social support transitions (SST), and the environment on QOL would be partly mediated by cognitive developmental transitions (CDT). Data sets were available from studies with random samples of community-dwelling older adults from Canada (n = 202) and Norway (n = 490). The partly and fully mediated effects found suggest positive CDT in older age might be significantly enhanced by the presence of intimate ties, positive perceptions of one's health limitations, and residence in a healthy, safe, and resource-rich physical environment. These findings represent a novel attempt at testing complex linkages between aspects of elder, environment, and nursing concepts within the Iowa model warranting further research.