Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long-term care: A correlational study using the salutogenic model

AIMS

This study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long-term care setting.

DESIGN

A cross-sectional, descriptive correlational study.

METHOD

The study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor-Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument-older adults (WHOQOL-OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product-moment correlation coefficient, independent-samples t test, one-way analysis of variance and stepwise regression were utilised in the analysis.

RESULTS

The mean score for WHOQOL-OLD was 94.42 ± 19.55. The highest mean score was observed in the "Death and Dying" facet, while the lowest mean scores were reflected in the "Autonomy" and "Intimacy" facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL.

CONCLUSION

Manageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long-term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention.

IMPACT

Future interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults' care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.

A salutogenic inquiry into positive aging - a longitudinal analysis

Objectives: Based on a gero-salutogenic approach, we investigated the stability of the sense of coherence over a time span of four years in active older individuals and long-term effects of this life orientation on three different indicators of positive aging-subjective well-being, psychological health and physical health. This is the first study to explore associations between gain in sense of coherence and future positive aging. Methods: Our longitudinal sample consisted of 125 physically active individuals (73.5% women) at the mean age of 71 years at follow-up (range: 64 to 87 years; response rate: 73.5%), who completed our questionnaire twice. There were no systematic differences between the follow-up responders and non-responders. Results: The sense of coherence increased over four years, disclosing a small effect size. The baseline sense of coherence had a substantial predictive value for future subjective well-being and psychological health, but not for physical health. Stepwise hierarchical regression analyses showed that both the baseline sense of coherence and gain in sense of coherence predicted future subjective well-being and psychological health. With respect to future physical health, only gain in sense of coherence was significant. Conclusion: Consistent with gero-salutogenic theory, the baseline sense of coherence is an effective predictor of future positive aging, and growth in sense of coherence within a time span of four years is reflected in improved positive aging. It is important to encourage experiences in older age that cultivate the three components of the sense of coherence-feelings of comprehensibility, manageability and meaningfulness.