Predicting wellness among rural older Australians: a cross- sectional study
Predicting wellness among rural older Australians: a cross- sectional study
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DOI：
10.22605/rrh4547
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发表时间：
2018-01-01
影响因子：
2.1
通讯作者：
Hancock, Shaun
中科院分区：
文献类型：
--
作者：
Hodgkin, Suzanne P.;Warburton, Jeni;Hancock, Shaun
导言：先前对老年人的幸福感和生活质量的研究缺乏清晰度和一致性。调查老年人健康的研究倾向于交替使用这些不同的术语和测量工具，这可能解释了为什么证据有些混乱。在农村老年人中使用多维健康结构的研究很少。针对这两方面的限制，本研究试图对健康的生态模型的知识测试做出独特的贡献，该模型包括个人因素、人际过程、制度因素、社区因素和公共政策。方法：在澳大利亚昆士兰州和维多利亚州的两个地点选择了六个农村案例研究地点。采用社区饱和招聘策略。电话调查了各地区居住在社区的农村老年人（n=266），年龄在50 ~ 65岁之间。该研究的中心变量是通过感知健康调查测量的健康。开发的生态模型包括以下个人因素：身心健康、孤独和社会人口特征（年龄、性别、婚姻状况和经济能力）。人际因素包括社会和社区团体参与、社会网络规模和提供的支持。制度因素是通过围绕资源基础环境和获得便利设施和服务设计的一系列问题来衡量的。结果：进行了层次回归分析，以确定模型中的哪些变量预测健康。结果表明，个人因素（身体健康、心理健康、孤独感和经济能力）和人际因素（社会网络规模和社区参与）共同预测了健康状况。然而，体制因素、资源基础环境以及便利设施和服务的获取对该模式的贡献很小。社区因素，包括社区的个人和物理特征，也只起到了很小的作用。结论：该研究确定了在健康测量中使用综合模型的有效性。这一模式认识到影响农村老年人整个生命历程的相互关联的物质、社会和经济影响。研究发现，身体健康对感知健康的贡献最大，其次是心理健康。这些发现支持了一项研究，该研究发现农村老年人的健康状况比城市老年人差。较低的孤独感也是感知健康的一个强有力的预测指标，从而支持了研究孤独感对身心健康影响的研究。社会资本的存在（通过社会网络规模来衡量）和社区参与程度也是感知健康的预测因素。总的来说，本研究的结果对旨在提高农村老年人健康能力的政策以及随后的战略具有影响。这种战略需要考虑到一系列因素的作用。
Introduction: Prior research on older people's wellbeing and quality of life has lacked clarity and consistency. Research examining older people's health has tended to use these different terms and measurement tools interchangeably, which might explain why the evidence is somewhat mixed. There is a paucity of research that uses the multi-dimensional construct of wellness in rural older people. Addressing both limitations, this study seeks to make a unique contribution to knowledge testing an ecological model of wellness that includes intrapersonal factors, interpersonal processes, institutional factors, community factors and public policy.Methods: Six rural case study sites were chosen across two Australian sites, the states of Queensland and Victoria. A community saturation recruitment strategy was utilised. Telephone surveys were conducted with community-dwelling rural older people (n=266) aged >= 65 years across the sites. The central variable of the study was wellness as measured by the Perceived Wellness Survey. The ecological model developed included the following intrapersonal factors: physical and mental health, loneliness and social demographic characteristics (age, sex, marital status and financial capability). Interpersonal factors included a measure of social and community group participation, social network size and support provided. Institutional factors were measured by series of questions devised around the resource base environment and access to amenities and services.Results: A hierarchical regression analysis was conducted to determine which variables in the model predict wellness. The results showed that a combination of intrapersonal factors (physical health, mental health, loneliness and financial capability) and interpersonal factors (size of social network and community participation) predicted wellness. However, institutional factors, the resource base environment, and access to amenities and services, contributed only marginally to the model. Community factors, including the personal and physical characteristics of community, also only made a marginal contribution.Conclusions: The study identified the usefulness of using an integrated model of measurement in wellness. This model recognised the interrelated physical, social and economic influences that impact on rural older people throughout their life course. The study found that physical health made the greatest contribution to perceived wellness, followed by mental health. These findings support a body of research that has found that rural older people experience poorer health outcomes than those in urban areas. Lower levels of loneliness were also a strong predictor of perceived wellness, thus supporting research that has examined the impact of loneliness on physical and mental health. The presence of social capital, as measured by social network size, and the degree of community participation, were also predictors of perceived wellness. Overall, the findings of the present study implications for policy as well as subsequent strategies designed to increase the capacity of wellness in rural older people. Such strategies need to consider the contribution of a range of factors.