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.
This study aims to explore how intimacy, physical and psychological health, loneliness, and attitudes to ageing at a time of loss affect the overall quality of life (QoL) of nondepressed and depressed older adults.
This was a randomised, stratified, cross-sectional study with two subsamples: depressed (n=74; mean: 77.9 years; 65% female) and nondepressed (n=356; mean: 75.0 years; 55% female), and based on the Geriatric Depression Scale-15.
Physical health accounted for the greatest variance in overall QoL in the nondepressed group; psychological health, losses, and feelings of intimacy also made significant contributions. In the depressed group, intimacy made the strongest contribution, while psychological health came a close second.
Physical health, psychological health, and loss were important to the QoL of nondepressed older adults, while intimacy was important for QoL in both depressed and nondepressed older adults. For those who are depressed, feelings of intimacy, in the form of having opportunities to express and receive love, are especially relevant and should be assessed by health professionals when planning interventions.
We used the Self-Concept Enhancement Tactician (SCENT) model to explore whether older Norwegians and Canadians would tactically self-enhance on qualities considered significant within their cultures in their self-perceptions of aging. Qualities were measured using the WHOQOL-BREF and WHOQOL-OLD. Self-perceptions of aging were measured by the Attitudes to Aging Questionnaire. The study is a secondary analysis of data collected in a larger study; 393 older Norwegians and 202 older Canadians were included. The Norwegian and Canadian group self-enhanced their perceptions of psychosocial loss based on harmonious social relationships and being part of a larger social group. For self-perceptions of physical change, both groups self-enhanced on being self-sufficient and being part of a larger social group. Our findings suggest that Norwegians and Canadians are not highly individualistic people and also provide evidence of a bicultural self-perception of aging. Nurses should consider how cultural and individual perspectives affect the care priorities of older people.
The aim of this study was to explore how depressive symptoms, physical function, health satisfaction, age, and environmental conditions predict quality of life (QoL) in a conceptual model based on the Wilson and Cleary's Model (WCM). A stratified sample by age, gender, and living area was drawn from the Norwegian population of older adults receiving community health care (mean age of 78.6 years, 94.4% living at home, 5.6% living in nursing homes). The study is part of a larger international study. Face-to-face interviews were conducted using the WHOQoL-Old, the WHOQoL-Bref Environment domain, the Geriatric Depression Scale, the Short Form SF-12, and sociodemographic and health questions. A path analysis (structural equation modeling) showed that the overall model provided empirical evidence for linkages in the WCM. QoL was manifested by significant direct effects of environmental conditions and health satisfaction. In addition, environmental conditions had indirect effects on QoL, in particular via depressive symptoms and health satisfaction. This model may help nurses in community health care to collect and assess information, to suggest suitable interventions, and to guide decision making.
BACKGROUND: there is limited research examining the relative importance of aspects of quality of life (QOL) to older adults across cultures. OBJECTIVE: to examine the relative importance of 31 internationally agreed areas of QOL to older adults in 22 countries in relation to health status, age and level of economic development. DESIGN: a survey quota sampling design was used to collect cross-cultural data. This study reports a secondary analysis of WHOQOL-OLD pilot study, which was collected simultaneously in 22 centres. Settings: a variety of community, primary, secondary and tertiary health care settings located in Australia, France, Switzerland, England, Scotland, USA, Israel, Spain, Japan, China (mainland and Hong Kong), Turkey, Lithuania, Czech Republic, Hungary, Canada, Norway, Sweden, Denmark, Germany, Brazil and Uruguay. Participants: the total sample contained 7,401 people over 60 years with a mean age of 73.1 years; 57.8% were women and 70.1% considered themselves 'healthy'. RESULTS: there were significant differences in the importance given to various aspects of QOL for people living in medium and high-development countries. Culture explained 15.9% of the variance in the importance ratings of QOL. However, the interaction showed that cultural differences were reduced once health status, gender and age were taken into account. The importance of QOL to age bands in different cultures was not significantly affected by whether or not participants perceived themselves to be healthy. CONCLUSION: understanding the self-reported importance of diverse aspects of QOL for different cultures and for healthy and less healthy people may assist national and international policy makers to decide on priorities for the development of programmes for the ageing population.
The aim of this cross-sectional comparative exploratory study was to explore the term spirituality as defined by four groups of nurses and two groups of caregivers from Malta and Norway.
Spirituality is a complex subjective concept which may or may not contain religiosity. Several factors may influence the individual's interpretation with implications to nursing care and nursing management.
Data were collected from six purposive samples using focus group discussions in Malta and Norway. The Taxonomy of Spirituality guided the study.
Four themes defined the term 'spirituality'. Two differences were found between Malta and Norway. Connectedness with family and nature was emphasized more by the Maltese group while the Norwegian group identified both the positive and the negative energies of spirituality.
A clinical environment conducive to holistic care is needed. Inclusion of spirituality in the continuous professional development programmes may enhance understanding of spirituality and foster spiritual growth.
Irrespective of differences in cultures between Malta and Norway, commonalities were found in the definition and essence of spirituality in nursing care. Trans-cultural longitudinal research is recommended to explore further the definition of spirituality.
Chronic illness is defined as a long-term disease that challenges a person's physical, psychological and spiritual wellbeing. However, individuals may adapt to their condition by adopting spiritual coping strategies that may or may not include religiosity. Part 1 of this article presents the methodology of this cross-sectional comparative study, which explored the spiritual coping of patients with chronic illness receiving rehabilitation services in Malta (n=44: lower limb amputation n=10; chronic heart disease n=9; osteoarthritis-in an institution n=10 and in the community n=15); and in Norway (n=16: post-hip/shoulder surgery n=5; chronic heart disease n=5; chronic pain n=6). Data were collected from seven purposive samples during focus group sessions. Roy's Adaptation Model (1984) and Neuman's Systems Model (2010) guided the study. While acknowledging the limitations of this study, the findings presented in Part 2 identify commonalities in the spiritual coping of patients irrespective of cultural differences between Malta and Norway. A set of recommendations address clinical practice, education and further research.