Developing and testing a model of quality of life among chronically-ill, community-dwelling older adults: A structural equation model
Developing and testing a model of quality of life among chronically-ill, community-dwelling older adults: A structural equation model
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DOI：
10.1016/j.archger.2018.07.013
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发表时间：
2018-09-01
影响因子：
4
通讯作者：
Macindo, John Rey B.
中科院分区：
文献类型：
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作者：
Buco, Claudia Erika Amor M.;Buenviaje, Keith Anthony C.;Macindo, John Rey B.
目的：虽然健康老龄化的目的是提高生活质量，但老年人无法充分照顾自己和健康，从而损害了这一目标的实现。而且，在菲律宾这样的集体主义社会，家庭、社区和超越对于提高生活质量是密不可分的。本研究开发并测试了社区居住的慢性病老年人的生活质量 (QoL) 模型。 材料和方法：2017 年 8 月至 11 月，对来自菲律宾选定农村社区的 304 名社区居住的慢性病老年人进行了一项横断面研究。受访者完成了由五部分组成的调查包，包括社会人口概况、改良的老年人生活质量、精神评估量表、高血压自我护理概况和糖尿病自我管理问卷。结果：社会人口、社区满意度、精神和疾病自我管理占生活质量的29.00%，生成了一个很好的模型（chi(2)/df = 1.44，RMSEA = 0.038，PNFI = 0.64）。灵性（beta = 0.34，p < 0.01）是生活质量最强的预测因素，而社区满意度则具有直接（beta = 0.26，p < 0.01）和间接（beta = 0.08，p < 0.01）影响。疾病自我管理直接（beta = 0.15，p = 0.016）影响生活质量。相比之下，较长的慢性病和较大的家庭规模会损害生活质量。 结论：社区居住的慢性病老年人的生活质量是一个多方面的健康结构，受社会人口统计、疾病自我管理、社区满意度和精神信仰的影响。所提出的模型强调了疾病自我管理、社区满意度和灵性的积极影响，可用于制定适当的基于社区的老年病战略、政策和计划。此外，可以尝试与社会活跃的社区老年人和基于社区的自我护理计划组建合作小组，以满足老年人的需求。
Purpose: Although healthy ageing aims for better quality of life, the inability of older adults to adequately care for themselves and their health impair the realization of such objective. Moreover, in a collectivist community like the Philippines, the family, community, and Transcendent are inseparable in promoting quality of life. This study developed and tested a model of quality of life (QoL) among chronically-ill, community-dwelling older adults.Materials and Methods: From August to November 2017, a cross-sectional study of 304 chronically-ill, community-dwelling older adults from selected rural communities in the Philippines was conducted. Respondents completed a five-part survey packet composed of the socio-demographic profile, modified Older People's Quality of Life, Spirituality Assessment Scale, Hypertension Self-Care Profile, and Diabetes Self-Management Questionnaire.Results: Socio-demographics, community satisfaction, spirituality, and disease self-management accounted 29.00% of QoL, generating a good model (chi(2)/df = 1.44, RMSEA = 0.038, and PNFI = 0.64). Spirituality (beta = 0.34, p < 0.01) was the strongest predictor of QoL, while community satisfaction had both direct (beta = 0.26, p < 0.01) and indirect (beta = 0.08, p < 0.01) effects. Disease self-management directly (beta = 0.15, p = 0.016) influenced QoL. In contrast, longer chronicity and larger family size impair QoL.Conclusion: Quality of life among chronically-ill, community-dwelling older adults is a multi-faceted health construct influenced by socio-demographics, disease self-management, community satisfaction, and spirituality. The presented model highlights the positive effect of disease self-management, community satisfaction, and spirituality which can be utilized in developing appropriate community-based geriatric strategies, policies, and programs. Further, forming collaborative groups with socially-active community elderly and community-based self-care programs can be ventured to address the needs of older adults.