Influence of Social Determinants of Health on the Quality of Life of Older Adults in Europe: A Sex Analysis

Introduction

The global aging population poses challenges for society such as health inequalities among older persons and between genders.

Objectives

To determine how Social Determinants of Health (SDH) influence the quality of life (QoL) of individuals over 50 years old in various European countries, taking a gender perspective in a longitudinal study.

Materials and methods

Sample of 11,493 individuals from 13 European countries from Waves 5 (2013), 6 (2015), and 7 (2017) of the SHARE study. Instruments: CASP-12 (QoL), EURO-D (depression), SDH: gender, age, educational level, socioeconomic status, ethnicity, place of residence, and European region. Sociodemographic and clinical variables. Statistical analysis: Bivariate and multivariate mixed linear models.

Results

The bivariate analysis showed higher economic hardship and lower education in women compared to men. The CASP-12 score was higher in men than in women. In the multivariate analysis, the variables associated with lower QoL scores among men and women from Wave 5 to Wave 7 were: (β:-0.196, 95% CI: -0.345; -0.047) vs (β:0.038, 95% CI: -0.122; 0.197); economic hardship; and the European region between South and North (β: 2.709, 95% CI: 2.403; 3.015) vs men (β: 2.224, 95% CI: 1.896; 2.551).

Conclusions

The main SDH associated with poorer QoL were female gender, advanced age, economic hardship, educational level, and geographic location within Europe. Depression in women and in Southern Europe were associated with a decrease in QoL scores.

Development and Validation of a Questionnaire of the Perioperative Nursing Competencies in Patient Safety

(1) Background: This research presents the CUCEQS© (Spanish acronym for Questionnaire of Perioperative Nursing Safety Competencies), which evaluates the perception of perioperative nurses about their competencies related to surgical patient safety. The aim of the present study was to design, validate, and analyze the psychometric properties of the CUCEQS©. (2) Methods: We devised an instrumental, quantitative, and descriptive study divided into two phases: in the first, the questionnaire was designed through a Delphi method developed by perioperative nurses and experts in patient safety. In the second, the reliability, validity, and internal structure of the tool were evaluated. (3) Results: In the first phase, the items kept were those that obtained a mean equal to or higher than four out of five in the expert consensus, and a Content Validity Index higher than 0.78. In the second phase, at the global level, a Stratified Cronbach's Alpha of 0.992 was obtained, and for each competency, Cronbach's Alpha values between 0.81 and 0.97 were found. A first-order confirmatory factor analysis of the 17 subscales (RMSEA 0.028, (IC 90% = 0.026-0.029) and its observed measures was performed for the 164 items, as well as a second-order analysis of the four competencies (RMSEA = 0.034, (IC90% = 0.033-0.035). (4) Conclusions: The questionnaire is a valid tool for measuring the perceived level of competency by the perioperative nurses in surgical patient safety. This is the first questionnaire developed for this purpose, and the results obtained will facilitate the identification of areas to be improved by health professionals in patient safety.