Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T02:13:49.308Z Has data issue: false hasContentIssue false

Lay theories of quality of life in older age

Published online by Cambridge University Press:  25 October 2007

ANN BOWLING*
Affiliation:
Department of Primary Care and Population Sciences, University CollegeLondon.
ZAHAVA GABRIEL
Affiliation:
Department of Primary Care and Population Sciences, University CollegeLondon.
*
Address for correspondence:Department of Primary Care and Population Sciences, University College London, Hampstead Campus, London NW3 2PF. email: [email protected]

Abstract

This paper presents findings from a national survey of quality of life (QoL) in older age. The main aim of the analyses was to examine the definitions of quality of life given by people aged 65 or more years and the underlying reasons. Open-ended questions were used to elicit their perceptions of QoL. These were followed by structured measures of self-rated QoL overall, and of domains of QoL commonly reported in the literature. The main things said by the respondents to give their lives quality were categorised into ‘themes’. These were: social relationships; social roles and activities; leisure activities enjoyed alone; health; psychological outlook and wellbeing; home and neighbourhood; financial circumstances; and independence. The reasons people gave to explain why these things were important to their QoL focused on: the freedom to do the things they wanted to do without restriction (whether in the home or socially); pleasure, enjoyment and satisfaction with life; mental harmony; social attachment and having access to companionship, intimacy, love, social contact and involvement, help; social roles; and feeling secure. This paper also presents data that demonstrates the ability of theoretically informed, structured survey indicators of QoL to predict respondents' self-rated overall QoL. Logistic regression analyses showed that most of these indicators were strong, independent predictors of self-ratings of QoL, although those that were not significant in the model did not fully incorporate lay reasons of QoL in their measurement scales. In conclusion, the indicators which were not significant in the model did not fully incorporate lay values in their measurement properties. It is also likely that those indicators that were significant could have been improved.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, F. M. (ed.) 1986. Research on the Quality of Life. Institute for Social Research, University of Michigan, Ann Arbor, Michigan.Google Scholar
Andrews, F. M. and Withey, S. B. 1976. Social Indicators of Well-being: American's Perceptions of Life Quality. Plenum, New York.CrossRefGoogle Scholar
Atchley, R. C. 1989. The continuity theory of normal aging. The Gerontologist, 29, 183–90.Google Scholar
Baltes, P. B. and Baltes, M. M. (eds) 1990. Successful Aging: Perspectives from the Behavioral Sciences. Cambridge University Press, New York.CrossRefGoogle Scholar
Bengston, V. L. and Schaie, K. W. (eds) 1999. Handbook of Theories of Ageing. Springer Publishing Company, New York.Google Scholar
Berkman, L. F. and Glass, T. 2000. Social integration, social networks, social support and health. In Berkman, L. F. and Kawachi, I. (eds), Social Epidemiology. Oxford University Press, Oxford, 137–73.CrossRefGoogle Scholar
Bowling, A. 1994. Social networks and social support among older people and implications for emotional well-being and psychiatric morbidity. International Review of Psychiatry, 9, 447–59.Google Scholar
Bowling, A. 2001. Measuring Disease: A Review of Disease Specific Quality of Life Measurement Scales. Second edition, Open University Press, Maidenhead, Berkshire.Google Scholar
Bowling, A. 2002. Research Methods in Health. Investigating Health and Health Services. Open University Press, Maidenhead, Berkshire.Google Scholar
Bowling, A. 2005 a. Measuring Health: A Review of Quality of Life Measurement Scales. Third edition, Open University Press, Maidenhead, Berkshire.Google Scholar
Bowling, A. 2005 b. Ageing Well. Quality of Life in Old Age. Open University Press, Maidenhead, Berkshire.Google Scholar
Bowling, A. and Gabriel, Z. 2004. An integrational model of quality of life in older age: a comparison of analytic and lay models of quality of life. Social Indicators Research, 69, 136.CrossRefGoogle Scholar
Bowling, A., Banister, D., Sutton, S., Evans, O. and Windsor, J. 2002. A multidimensional model of QoL in older age. Ageing and Mental Health, 6, 355–71.CrossRefGoogle ScholarPubMed
Bowling, A., Gabriel, Z., Dykes, J., Marriott-Dowding, L., Evans, L., Fleissig, A., Banister, D. and Sutton, S. 2003. Let's ask them: a national survey of definitions of quality of life and its enhancement among people aged 65 and over. International Journal of Aging and Human Development, 56, 269306.CrossRefGoogle ScholarPubMed
Carver, D. J., Chapman, C. A., Thomas, V. S., Stadnyk, K. J. and Rockwood, K. 1999. Validity and reliability of the Medical Outcomes Study Short Form-20 questionnaire as a measure of quality of life in elderly people living at home. Age and Ageing, 28, 169–74.CrossRefGoogle ScholarPubMed
Cohen, S. 1988. Psychosocial models of the role of social support in the etiology of physical disease. Health Psychology, 7, 269–97.CrossRefGoogle ScholarPubMed
Cohen, S. and Syme, S. L. 1985. Issues in the study and application of social support. In Cohen, S. and Syme, S. L. (eds), Social Support and Health. Academic, Orlando, Florida, 122.Google Scholar
Cooper, K., Arber, S., Fee, L. and Ginn, J. 1999. The Influence of Social Support and Social Capital on Health: A Review and Analysis of British Data. Health Education Authority, London.Google Scholar
Cumming, E. and Henry, W. 1961. Growing Old: The Process of Disengagement. Basic, New York.Google Scholar
Donovan, D. and Saunders, C. 2005. Key issues in the analysis of qualitative data in health services research. In Bowling, A. and Ebrahim, S. (eds), Handbook of Health Research Methods: Investigation, Measurement and Analysis. Open University Press, Maidenhead, Berkshire, 515–32.Google Scholar
Doyal, L. and Gough, I. 1991. A Theory of Human Need. Macmillan, London.CrossRefGoogle Scholar
Fayers, P. M. and Hand, D. J. 2002. Causal variables, indicator variables and measurement scales: an example from quality of life. Journal of the Royal Statistical Association, 165, 2, 121.Google Scholar
Fisher, B. J. 1995. Successful aging, life satisfaction, and generativity in later life. International Journal of Aging and Human Development, 41, 239–50.Google Scholar
Gabriel, Z. and Bowling, A. 2004. Perspectives on quality of life in older age: older people talking. Ageing and Society, 24, 675–91.CrossRefGoogle Scholar
Goldberg, D. P. and Williams, P. 1988. A User's Guide to the General Health Questionnaire. NFER-Nelson, Windsor, Berks.Google Scholar
Grundy, E. and Bowling, A. 1999. Enhancing the quality of extended life years. Identification of the oldest old with a very good and very poor quality of life. Ageing and Mental Health, 3, 199212.CrossRefGoogle Scholar
Grundy, E.Bowling, A. and Farquhar, M. 1996. Social support, life satisfaction and survival at older ages. In Casselli, G. and Lopez, A. (eds), Health and mortality among elderly populations. pp. 135–56. Clarendon Press, Oxford.Google Scholar
Haywood, K. L., Garratt, A. M., Mackintosh, A. E. and Fitzpatrick, R. 2004. Health Status and Quality of Life in Older People. A Structured Review of Patient-assessed Health Instruments. Patient-assessed Health Instruments Group, University of Oxford, Oxford.Google Scholar
Higgs, P., Hyde, M., Wiggins, R. and Blane, D. 2003. Researching quality of life in early old age: the importance of the sociological dimension. Social Policy and Administration, 37, 239–52.CrossRefGoogle Scholar
Hyde, M., Wiggins, R. D., Higgs, P. and Blane, D. 2003. A measure of quality of life in early old age: the theory, development and properties of a needs satisfaction model (CASP-19). Ageing and Mental Health, 7, 186–94.CrossRefGoogle ScholarPubMed
Lau, R. R., Hartman, K. A. and Ware, J. E. 1986. Health as a value: methodological and theoretical considerations. Health Psychology, 5, 2543.CrossRefGoogle ScholarPubMed
Lawton, M. P. 1982. Competence, environmental press and adaptation of older people. In Lawton, M. P., Windley, P. G. and Byerts, T. O. (eds), Aging and environment. Theoretical approaches. Springer, New York.Google Scholar
Lawton, M. P. 1983 a. Environment and other determinants of well-being in older people. Gerontologist, 23, 349–57.CrossRefGoogle ScholarPubMed
Lawton, M. P. 1983 b. The varieties of wellbeing. Experimental Aging Research, 9, 6572.CrossRefGoogle ScholarPubMed
Lawton, M. P. 1991. A multidimensional view of quality of life in frail elders, In Birren, J. E., Lubben, J., Rowe, J. and Deutchman, D. (eds), The concept and measurement of quality of life in the frail elderly. pp. 427. Academic Press, San Diego, CA.Google Scholar
Lawton, M. P. 1996. Quality of life and affect in later life. In Magai, C. and McFadden, S. H. (eds), Handbook of emotion, human development, and aging. pp. 327–48. Academic Press, San Diego, CA.CrossRefGoogle Scholar
Maslow, A. 1954. Motivation and Personality. Harper, New York.Google Scholar
Maslow, A. H. 1968. Toward a Psychology of Being. 2nd ed.Van Nostrand, Princeton, New Jersey.Google Scholar
Miller, B. and McFall, S. 1991. Stability and change in the informal task social support network of frail older persons. The Gerontologist, 31, 735–45.CrossRefGoogle ScholarPubMed
O'Boyle, C. A. 1997. Quality of life assessment: a paradigm shift in healthcare? Irish Journal of Psychology, 18, 510–66.Google Scholar
Office for National Statistics 2000. Standard Occupational Classification. ‘Volume 1: Structure and Descriptions of Unit Groups’ and ‘Volume 2: The Coding Index’. Office for National Statistics, London.Google Scholar
Popay, J. 2006. Whose theory is it anyway? Journal of Epidemiology and Community Health, 60, 571–72.Google Scholar
Procidano, M. E. and Heller, K. 1983. Measures of perceived social support from friends and from family: three validation studies. American Journal of Community Psychology, 11, 124.CrossRefGoogle ScholarPubMed
Rogerson, R. J., Findlay, A. M., Coombe, M. G. and Morris, A. 1989. Indicators of quality of life. Environment and Planning, 21, 1655–66.Google Scholar
Sarvimäki, A. and Stenbock-Hult, H. B. 2000. Quality of life in old age described as a sense of well-being, meaning and value. Journal of Advanced Nursing, 32, 1025–33.Google Scholar
Schwarzer, R. 1993. Measurement of Perceived Self-efficacy: Psychometric Scales for Cross-cultural Research. Institute for Psychology, Free University of Berlin, Berlin.Google Scholar
Scheier, M. F. and Carver, C. S. 1985. Optimism, coping, and health: assessment and implications of generalised outcome expectancies. Health Psychology, 4, 219–47.Google Scholar
Seeman, T. A. and Crimmins, E. 2001. Social environment effects on health and ageing: integrating epidemiological and demographic approaches and perspectives. In Weinstein, M., Hermalin, A. I. and Stoto, M. A. (eds), Population Health and Aging: Strengthening the Dialogue Between Epidemiology and Demography. New York Academy of Sciences, New York, 88117.Google Scholar
Seeman, T. E., Lusignolo, T. M., Albert, M. and Berkman, L. 2001. Social relationships, social support, and patterns of cognitive aging in healthy, high functioning older adults: MacArthur studies of successful ageing. Health Psychology, 20, 243–55.CrossRefGoogle Scholar
Sherbourne, C. D. and Stewart, A. L. 1991. The MOS social support survey. Social Science and Medicine, 32, 705–14.Google Scholar
Skevington, S. M. 1999. Measuring quality of life in Britain: introducing the WHOQOL-100. Psychomatic Research, 47, 449–59.CrossRefGoogle ScholarPubMed
Skevington, S. M., O'Connell, K. A. and the WHOQOL Group. 2004. Can we identify the poorest quality of life? Assessing the importance of quality of life using the WHOQOL-100. Quality of Life Research, 13, 2334.CrossRefGoogle ScholarPubMed
Skevington, S. M., Lotfy, M. and O'Connell, K. A. 2004. The World Health Organization's WHOQOL-BREF quality of life assessment: psychometric properties and results from international field trials. A report from the WHOQOL Group. Quality of Life Research, 13, 299310.Google Scholar
Stenner, P. H. D., Cooper, D. and Skevington, S. M. 2003. Putting the Q into quality of life; the identification of subjective constructions of health-related quality of life using Q methodology. Social Science and Medicine, 57, 2161–72.Google Scholar
Townsend, P. 1979. Poverty in the United Kingdom. Pelican, Harmondsworth, Middlesex.CrossRefGoogle Scholar
Ware, J. E., Snow, K. K., Kosinski, M. and Gandek, B. 1993. SF-36 Health Survey: Manual and Interpretation Guide. The Health Institute, New England Medical Center, Boston, Massachusetts.Google Scholar
Ware, J. E., Snow, K. K., Kosinski, M. and Gandek, B. 1997. SF-36 Health Survey: Manual and Interpretation Guide. Revised edition, The Health Institute, New England Medical Center, Boston, Massachusetts.Google Scholar
World Health Organisation. 1993. Measuring Quality of Life: the Development of the World Health Organization Quality of Life Instrument (WHOQOL). WHO, Geneva.Google Scholar