Factors associated with quality of life of Brazilian older adults

Disaster response self-efficacy of nursing students: Perceived level and associated factors

OBJECTIVES

The study aimed to assess the level of disaster response self-efficacy (DRSE) among nursing students in Bangladesh and examine the factors influencing their level of DRSE.

METHODS

A cross-sectional study design was used for this research. A self-administered descriptive structured questionnaire was used to collect survey data from 573 students of nursing colleges in four districts: Chattogram, Dhaka, Khulna, and Rajshahi. The Bengali version of the DRSE Scale was adopted and used to measure the outcome variable.

RESULTS

The nursing students exhibited a moderate level of disaster response self-efficacy (Mean = 3.63; SD = 0.73), as well as moderate levels of knowledge (Mean = 3.87; SD = 0.71), skills (Mean = 4.24; SD = 0.91), and preparedness (Mean = 4.31; SD = 0.76) in disaster management. Significant positive correlations were found between respondents' disaster knowledge (r = 0.447, p < 0.01), skills (r = 0.516, p < 0.01), and preparedness (r = 0.701, p < 0.01) with disaster response self-efficacy. Gender, age, having children in the household, post-basic BSc in nursing students, and disaster knowledge were significantly associated with nursing students' DRSE. Female respondents had a 0.27-unit lower DRSE (β = -0.270 (95 % CI: -0.389, -0.115), p < 0.001) than male respondents. Besides, the respondents per unit increase in disaster knowledge occurred a 0.438-unit increase in DRSE (β = 0.438 (95 % CI: 0.367, 0.510), p < 0.001). However, no statistically significant associations were found between the respondents' disaster experience and disaster-related training with their DRSE scores.

CONCLUSION

Improving disaster management knowledge by including disaster management-related courses and organizing more training, drills, seminars, and workshops may improve their DRSE.

Multivariate analysis of independent determinants of ADL/IADL and quality of life in the elderly

BACKGROUND

This study evaluated the determinants of disability and quality of life in elderly people who participated at the multi-centred RubiN project (Regional ununterbrochen betreut im Netz) in Germany.

METHODS

Baseline data of the subjects aged 70 years and older of the RubiN project were used and only subjects with complete data sets were considered for the ensuing analysis (complete case analysis (CCA)). Disability was examined using the concepts of ADL (activities of daily living) and IADL (instrumental activities of daily living). Subjects exhibiting one or more deficiencies in ADL respectively IADL were considered as ADL respectively IADL disabled. Quality of life was assessed using the WHOQOL-BREF and the WHOQOL-OLD. Applying multivariate analysis, sociodemographic factors, psychosocial characteristics as well as the functional, nutritional and cognitive status were explored as potential determinants of disability and quality of life in the elderly.

RESULTS

One thousand three hundred seventy-five subjects from the RubiN project exhibited data completeness regarding baseline data. ADL and IADL disability were both associated with the respective other construct of disability, sex, a reduced cognitive and functional status as well as domains of the WHOQOL-BREF. Furthermore, ADL disability was related to social participation, while IADL disability was linked to age, education and social support. Sex, ADL and IADL disability, income, social support and social participation as well as the functional status were predictors of the domain 'Physical Health' (WHOQOL-BREF). The facet 'Social Participation' (WHOQOL-OLD) was affected by both ADL and IADL disability, income, social participation, the nutritional and also the functional status.

CONCLUSIONS

Several potential determinants of disability and quality of life were identified and confirmed in this study. Attention should be drawn to prevention schemes as many of these determinants appear to be at least partly modifiable.

Quality of Life in Older Adults: Evidence from Mexico and Ecuador

Older adults are a growing population group in Latin America, hence the importance of deepening studies, proposals, and policies to guarantee their well-being. This article analyzes the perception of quality of life in older adults from Mexico and Ecuador and its association with several socioeconomic variables. The study design was cross-sectional. The sample comprised 450 older adults, 238 from Mexico and 212 from Ecuador. The WHOQOL-OLD Quality of Life Questionnaire and a set of sociodemographic variables were used. The results showed a higher perception of quality of life in the Mexican sample regarding most of the dimensions, except for sensory skills and social participation. An association was also found between sensory skills and sports practice, as well as between social participation and education level. The study achieves a binational approach to the reality of older adults in Latin America and confirms that there are differences in each sample that are due to the particularities of each reality. This research contributes to deepening the reality of the elderly, especially in Ecuador, where the quality-of-life studies in all age segments must be strengthened.

Quality of life of older adults in two contrasting neighbourhoods in Accra, Ghana

As is the case elsewhere in sub-Saharan Africa, Ghana is experiencing a rapid increase in the population of older adults. Despite their rising numbers, the living conditions and wellbeing of older Ghanaians remain woefully understudied. This paper presents the results of a study exploring the quality of life (QoL) of older adults in two contrasting neighbourhoods in Accra, Ghana. The objectives of the study were to: (1) explore and compare the QoL of older slum and non-slum dwellers in Ghana; and (2) determine the extent of QoL disparities between slum and non-slum older adults. To accomplish these objectives, we undertook a cross-sectional survey of older adults (N = 603) residing in a slum and non-slum neighbourhood. QoL was self-assessed in four domains - physical, psychological, social, and environment - using the World Health Organization (WHO) QoL assessment tool (WHOQoL-BREF). Multivariable linear regression analyses of the data revealed no statistically significant difference between the slum and non-slum respondents in physical (coeff: 0.5; 95% CI: -1.7, 2.8; p = 0.642) and psychological (coeff: -0.2; 95% CI: -3.0, 2.6; p = 0.893) QoL. However, the slum respondents reported significantly higher social QoL than the non-slum respondents (coeff: -3.2; 95% CI: -5.6, -0.8; p = 0.010), while the reverse was true in environmental QoL (coeff: 4.2; 95% CI: 2.3, 6.2; p < 0.001). The existence of strong social support systems in the slum and better housing and neighbourhood environmental conditions in the non-slum may have accounted for the observed variation in social and environmental QoL. Thus, contrary to popular discourses that vilify slums as health-damaging milieus, these findings offer a more nuanced picture, and suggest that some features of slums may constitute important health resources for older adults.

The Quality of Life of Seniors Hospitalized Due to Cardiovascular Diseases in Poland

INTRODUCTION

In the light of the increased ageing of the world population, social policy needs to be focused on actions aimed at improving the quality of life of older people.

OBJECTIVE

The main objective of this study was to assess the quality of life in a population of seniors hospitalized due to cardiovascular disease.

MATERIALS AND METHODS

The study included 408 elderly patients hospitalized for cardiovascular diseases in the Poddębickie Centrum Zdrowia Hospital in Poddębice, Łódzkie voivodship, Poland. The study used two survey questionnaires: the author's survey questionnaire and the standardized SF36v2 Questionnaire. Statistical analysis of the obtained test results was carried out in the R program, version 3.5.1.

RESULTS

Having analyzed the health status of the study group, it was found that the largest group of subjects (84.07%) were treated due to hypertension. Among the ailments that hindered daily functioning, the respondents indicated primarily poor eyesight (53.68%). Patients assessed their own health as 'mediocre' (average) (58.58%). The analysis of the study results from the SF36v2 Questionnaire showed that the highest quality of life was in the limited activity due to emotional problems (RE) dimension, social functioning (SF), and physical functioning (PF); the weakest scores were observed in vitality (VT), general health perception (GH), and health transition (HT) dimensions.

CONCLUSIONS

The significant demographic, social and socio-medical factors that determined respondents' quality of life were: age, gender, marital status, education and health situation. The analysis of quality of life according to the SF36v2 Questionnaire showed that the study group functioned better in the mental dimension (MCS-mental component summary, overall mental health) than in the physical one (PCS-physical component summary, total physical health).

Quality of life perceptions of family caregivers of older adults stroke survivors: A longitudinal study

BACKGROUND

There are few formal outreach and out-patient support services to help family caring for older adults who have had a stroke in developing countries. Family caregivers experience negative changes in their quality of life.

AIM

To assess quality of life perceptions of spouse and non-spouse caregivers of older adult stroke survivors.

METHODS

A longitudinal survey study. A convenience sample of forty-eight family caregivers was recruited from the Special Care Stroke Unit at a University Hospital in South Brazil. Quality of life was measured using the World Health Organization's Quality of Life BREF survey upon discharge from the hospital (Time 1) and two months after (Time 2).

RESULTS

Non-spouse caregivers had the lowest Social Relationship scores at Time 1 (p < .001) and at Time 2 (p = .005), both in terms of personal relationship, the quality of their sex lives and support received from others.

CONCLUSION

Unfortunately, formal community support programs for family caregivers in Brazil are lacking. Post-stroke caregiving is largely a family affair. Quality of Life assessments among family caregivers of older adult stroke survivors are crucial, particularly after discharge.

VES-13 and WHOQOL-bref cutoff points to detect quality of life in older adults in primary health care

OBJECTIVE:

To determine Vulnerable Elders Survey (VES-13) and WHOQOL-bref cutoff points to detect poor quality of life (QoL) in older individuals.

METHODS:

This is a cross-sectional study, performed in all primary health care units in Samambaia, DF, Brazil. The data were collected from August 2016 to May 2017. The sample size of 466 older individuals treated in primary health care was obtained considering a 5% margin of error, 95% confidence level, 50% prevalence, and 20% possible losses, in a population of 13,259 older individuals. The subjects answered the VES-13 and WHOQOL-bref questionnaires. They were divided into 3 subgroups: poorQoL (older individuals with self-reported very poor or poor QoL AND very dissatisfied or dissatisfied with their health), goodQoL (very good or good QoL AND very satisfied or satisfied with Health) and indeterminateQoL (NOT belonging to poorQoL or goodQoL subgroups). A receiver-operating characteristic (ROC) curve was performed with poorQoL (case) versus goodQoL (control) to determine the cutoff score in VES-13 and WHOQOL-bref. A diagnostic test using these cutoffs was carried out in all older individuals (n = 466).

RESULTS:

The VES-13 and WHOQOL-bref cutoff points to detect poorQoL were ≥ 2 and < 60, respectively. The area under ROC curve of VES-13 and WHOQOL-bref was 0.741 (CI95% 0.659-0.823; p < 0.001) and 0.934 (CI95% 0.881-0.987; p < 0.001), respectively. In diagnostic tests, VES-13 showed 84% sensitivity and 98.2% negative predictive value, and WHOQOL-bref, 88% sensitivity and 99% negative predictive value.

CONCLUSIONS:

VES-13 score ≥ 2 and WHOQOL-bref score < 60 adequately detected poorQoL in patients treated in primary health care. Our data suggest that older individuals with these scores require special treatment such as geriatrics collaborative care to improve this scenario, considering QoL impact on mortality.

The effects of sociodemographic factors on quality of life among people aged 50 years or older are not unequivocal: comparing SF-12, WHOQOL-BREF, and WHOQOL-OLD

Objective

The effects of sociodemographic factors on quality of life in older people differ strongly, possibly due to the fact that different measurement instruments have been used. The main aim of this cross-sectional study is to compare the associations of sex, age, marital status, education, and income with quality of life assessed with the Short-Form Health Survey (SF-12), the World Health Organization Quality of Life Questionnaire-BREF (WHOQOL-BREF), and the World Health Organization Quality of Life Questionnaire-Older Adults Module (WHOQOL-OLD).

Methods

The associations between sociodemographic factors and eleven quality of life domains were examined using a sample of 1,492 Dutch people aged ≥50 years. Participants completed the “Senioren Barometer”, a web-based questionnaire including sociodemographic factors, the SF-12, the WHOQOL-BREF, and the WHOQOL-OLD.

Results

All the sociodemographic factors together explained a significant part of the variance of all the quality of life domains’ scores, ranging from 5% to 17% for the WHOQOL-BREF, 5.8% to 6.7% for the SF-12, and 1.4% to 26% for the WHOQOL-OLD. Being a woman and being older were negatively associated with two and four quality of life domains, respectively. Being a woman, being married or cohabiting, and having higher education and a higher income were positively associated with six, six, one, and eleven quality of life domains, respectively.

Conclusion

Our study showed that the associations of sociodemographic factors and quality of life in middle-aged and older people depend on the instruments used to assess quality of life. We recommend that health care and welfare professionals focus particularly on people with a low income and carry out interventions aimed at improving their quality of life.

Differences in quality of life among older adults in Brazil according to smoking status and nicotine dependence

BACKGROUND

Research on quality of life QOL is limited in Brazil and few studies have examined the association between smoking status and quality of life. This study addresses this gap and also examines the association between smoking, nicotine dependence, and duration of smoking cessation on (QOL) among older adults in an urban area in Brazil.

METHODS

Data are from a household survey conducted in urban areas of Uberaba, Brazil, in 2012 (n = 980). Multivariable linear regressions were used to evaluate the association between smoking, nicotine dependence based on Fageström test, and smoking cessation on the World Health Organization Quality of Life WHOQOL-BREF and Quality of Life Assessment for Older Adults WHOQOL-OLD.

RESULTS

The mean age of older adults in the study was 74.0 (SD = 6.9 years) and 64% of participants were women. The majority, 55% had never smoked, 12.4% were current smokers, and 32.7% were past-smokers. Current smokers had lower scores for social participation (β = - 2.6) and intimacy (β = - 3.8) than never smokers. Smokers with high or very high dependence reported higher levels of fear and concern about death and pain before death than those with low or very low dependence (β = - 10.6). However, smokers with medium levels of nicotine dependence had higher scores on social relationship. Longer cessation time was positively associated with higher scores for psychological health.

CONCLUSIONS

Except for the positive association between medium levels of nicotine dependence and better social relationships, smoking and higher levels of nicotine dependence were associated with worse QOL among older adults in Brazil. Nonetheless, smoking cessation had positive effects in QOL. Campaigns targeting older adults should point to the negative impact of tobacco use on QOL and the benefits of smoking cessation.

Health-Related Quality of Life among People Applying for Housing Adaptations: Associated Factors

Housing adaptations (HA) clients are a heterogeneous group of people with disabilities experiencing restricted performance and participation in everyday life. While health-related quality of life is a common and relevant outcome in health care research, associated factors among HA clients are largely unknown. Thus, the aim of this study was to investigate which factors are associated with health-related quality of life among HA clients in Sweden. The study has a cross-sectional design, using baseline data collected among 224 participants in three municipalities in Sweden. The main outcome was health-related quality of life measured by the EQ-5D. Factors investigated as potentially associated were age, sex, living conditions, cognitive impairment, usability of the home, activities of daily living (ADL) dependence, participation, and fear of falling. The associations were explored using multiple linear regression analysis. Younger age and higher dependence in ADL were associated with lower scores on the EQ-5D. The social aspect of usability in the home had a positive association with the EQ VAS. Results suggest that certain groups of HA clients might be at risk for low health-related quality of life. Knowledge of their characteristics can potentially improve development and implementation of tailored interventions aiming at increasing their health-related quality of life.

Motives to practice exercise in old age and successful aging: A latent class analysis

PURPOSE

The aim was to classify motives for exercising trying to find sets of related cases that share common motivations, and to relate these latent classes to markers of successful aging.

METHODS

725 old adult aged 55 to 97 years were sampled in several Spanish towns.

INSTRUMENTS

Successful Aging Inventory (SAI), International Physical Activity Questionnaire (IPAQ), Health Survey SF-8, Satisfaction with Life Scale (SWLS), and motives to practice exercise, were used. Latent Class Analyses (LCAs) were estimated. The classes obtained were compared on markers of successful aging.

RESULTS

Three latent classes were deemed optimal. Significant differences for several markers of successful aging were found.

CONCLUSION

A main conclusion derived from the results is that not all old people do exercise for the same motives, and the class of motives you are in had an impact/relation on markers of successful aging. Motives related to internal rather than external pressures should be promoted in the old age.

Quality of life and associated characteristics: application of WHOQOL-BREF in the context of Primary Health Care

This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains. The highest mean values of QOL were observed in the social relationships domain. The lowest means were observed in the environment domain, with a statistically significant difference between some of the UBS. The worst perceptions of QOL were related to worse health, housing, education and income conditions, as well as problems in social relationships and psychological conditions. Actions are needed to improve QOL in Primary Health Care users through actions promoted by both health professionals and public managers.

Relative Contributions of Different Lifestyle Factors to Health-Related Quality of Life in the Elderly

Much of the previous literature has studied the relationship between individual lifestyle factors and the health-related quality of life (HRQOL). However, only a few studies combined them to explore their relative importance to the HRQOL in the elderly. This study assesses the HRQOL of the urban, rural, and institutionalized Chinese elderly and explores the relative contributions of different lifestyle factors to their HRQOL. The SF-36v2 Health Survey, the WHOQOL-OLD module, and the socio-demographic and lifestyle questionnaire were utilized in this study. Hierarchical regression was performed in order to analyze the results. The physical and mental component scores of the SF-36v2 survey were 47.05 ± 9.95 and 54.92 ± 9.92, respectively. The total score for the WHOQOL-OLD module was 73.01 ± 11.99, with institutionalized persons reporting lower scores. For the physical component of the elderly participants’ HRQOL, the R² value changed the most (0.116) when exercise-and-labor-related factors were added in. For the mental component, sleep-related (0.054), and leisure-time-activity-related factors (0.053) caused the largest change of the R² value. For the elderly-specific HRQOL, measured by the WHOQOL-OLD module, the leisure-time-activity-related factors caused the largest change in the R² value (0.119), followed by exercise-and-labor-related factors (0.078). Heterogeneity was present among the three subgroups. In sum, compared with their community-dwelling counterparts, the HRQOL of institutionalized older people was relatively poor and different lifestyle factors contributed to the HRQOL differently.

Factors related to quality of life among older adults in Bangladesh: A cross sectional survey

This cross-sectional design study aimed to describe quality of life and examine factors related to quality of life among older adults in Bangladesh. Convenience sampling was used to recruit 280 older adults from ten villages in two southern districts. The results demonstrate that the majority of the participants reported an overall moderate score of quality of life. Moreover, participants' sleep problems, depression, religiosity, and activities of daily living were negatively correlated with quality of life whereas social support and health service availability were positively correlated with quality of life. Implementing intervention programs upon the significant related factors to improve older adults' quality of life is recommended.

Quality of Life and Its Factors in Korean Elderly With Mild Cognitive Impairment

Based on the secondary data analysis, this study aimed to identify quality of life and factors that affect quality of life among Korean elderly with mild cognitive impairment. Demographic characteristics, physical factors, and psychosocial factors as well as quality of life of the elderly with mild cognitive impairment were comprehensively measured. The research subjects consisted of 348 home-resident elderly and their quality of life scores were relatively high at 29.86. Their quality of life varied according to education and gender, and instrumental activities of daily living (actual, latent), somatic symptoms, sleep quality, depression, and social support affected their quality of life. Depression and social support were predictors of quality of life. The most powerful predictor was depression (β = −.583, p < .001). To improve the quality of life among elderly with mild cognitive impairment, nursing interventions to alleviate depression and to enhance social support from family, friends, and relevant neighbors are needed.

Self-rated health, multimorbidity and depression in Mexican older adults: Proposal and evaluation of a simple conceptual model

INTRODUCTION

Self-rated health is an individual and subjective conceptualization involving the intersection of biological, social and psychological factors. It provides an invaluable and unique evaluation of a person's general health status.

OBJECTIVE

To propose and evaluate a simple conceptual model to understand self-rated health and its relationship to multimorbidity, disability and depressive symptoms in Mexican older adults.

MATERIALS AND METHODS

We conducted a cross-sectional study based on a national representative sample of 8,874 adults of 60 years of age and older. Self-perception of a positive health status was determined according to a Likert-type scale based on the question: "What do you think is your current health status?" Intermediate variables included multimorbidity, disability and depressive symptoms, as well as dichotomous exogenous variables (sex, having a partner, participation in decision-making and poverty). The proposed conceptual model was validated using a general structural equation model with a logit link function for positive self-rated health.

RESULTS

A direct association was found between multimorbidity and positive self-rated health (OR=0.48; 95% CI: 0.42-0.55), disability and positive self-rated health (OR=0.35; 95% CI: 0.30-0.40), depressive symptoms and positive self-rated health (OR=0.38; 95% CI: 0.34-0.43). The model also validated indirect associations between disability and depressive symptoms (OR=2.25; 95% CI: 2.01- 2.52), multimorbidity and depressive symptoms (OR=1.79; 95% CI: 1.61-2.00) and multimorbidity and disability (OR=1.98; 95% CI: 1.78-2.20).

CONCLUSIONS

A parsimonious theoretical model was empirically evaluated, which enabled identifying direct and indirect associations with positive self-rated health.

Intervals between response choices on a single-item measure of quality of life

Background

A single overall rating of quality of life (QoL) is a sensitive method that is often used in population surveys. However, the exact meaning of response choices is unclear. In particular, uneven spacing may affect the way QoL ratings should be analyzed and interpreted. This study aimed to determine the intervals between response choices to a single-item QoL assessment.

Methods

A secondary analysis was conducted on data from the Lc65+ cohort study and two additional, population-based, stratified random samples of older people (N = 5,300). Overall QoL was rated as excellent, very good, good, fair or poor. A QoL score (range 0–100) was derived from participants’ answers to a 28-item QoL assessment tool. A transformed QoL score ranging from 1 (poor) to 5 (excellent) was calculated. The same procedure was repeated to compute seven domain-specific QoL subscores (Feeling of safety; Health and mobility; Autonomy; Close entourage; Material resources; Esteem and recognition; Social and cultural life).

Results

Mean (95 % confidence intervals) QoL scores were 96.23 (95.81–96.65) for excellent, 93.09 (92.74–93.45) for very good, 81.45 (80.63–82.27) for good, 65.44 (62.67–68.20) for fair and 54.52 (45.31–63.73) for poor overall QoL, corresponding to transformed QoL scores of respectively 5.00, 4.70, 3.58, 2.05, and 1.00. Ordinality of the categories excellent to poor was preserved in all seven QoL subscores.

Conclusions

The excellent-to-poor rating scale provides an ordinal measure of overall QoL. The intervals between response choices are unequal, but an interval scale can be obtained after adequate recoding of excellent, very good, good, fair and poor.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-016-0443-5) contains supplementary material, which is available to authorized users.

Level of physical activity and quality of life: a comparative study among the elderly of rural and urban areas

Objective : To investigate if the relationship between physical activity level (PAL) and quality of life (QOL) is affected by living environment (rural or urban). Method : A quantitative, observational and cross-sectional study was performed. Of the 40 participants of both genders, 20 were residents of urban areas and 20 were residents of rural areas in the town of Pimenta Bueno (RO), Brazil. The WHOQOL BREF and IPAQ Long Version questionnaires were used to assess QOL and PAL, respectively. Mann Whitney and Fisher's Exact were used to statistically compare groups for QOL and PAL scores. The correlation between the two was tested by the Spearman test. A significance level of p<0.05 was used. Results : No differences between the rural and urban areas for QOL or PAL were found. In the rural group a positive and significant correlation was found between PAL and the physical, psychological and complete QOL domains. In terms of PAL, elderly persons from the rural area who were regularly active had higher total QOL and physical domain scores than insufficiently active elderly individuals from the rural area. When place of residence was compared, insufficiently active elderly in the urban area had higher scores on the social component of QOL than insufficiently active elderly from the rural group. Among regularly active seniors, those living in the rural area had higher physical QOL scores. Conclusion : According to the results, level of physical activity exerts a differential influence on the QOL of elderly people from rural and urban areas.

[Aspects of quality of life associated with self-rated health: a study of elderly women from a physical activity program in low-income neighborhoods in Curitiba in the state of Paraná, Brazil]

This study sought to analyze which aspects of quality of life (QoL; Physical, Psychological, Social Relationships and Environmental) are associated with the perception of health among elderly women from low-income neighborhoods in Curitiba in the state of Paraná. The sample comprised 450 elderly participants of the Elderly in Motion Program of the Boqueirão, Pinheirinho and Bairro Novo neighborhoods. The question "How do you rate your general health?" was used to assess the perceived health in the elderly, and the Whoqol-Bref questionnaire was used to identify the aspects of QoL. Descriptive statistics, the Mann-Whitney U test, Spearman's correlation test and binary logistic regression were used for data analysis. All aspects were significantly associated with perceived health (p < 0.05). However, after adjusting for confounding variables, only the Physical and Environmental aspects revealed significant associations. In other words, elderly women with a negative perception of these aspects were twice as likely to have a negative perception of health. The conclusion reached is that programs aimed at promoting health and QoL in low-income elderly women ought to concentrate their actions on the physical and environmental aspects of QoL.

Análise comparativa da qualidade de vida de adultos e idosos envolvidos com a prática regular de atividade física

OBJETIVO: Identificar diferenças na qualidade de vida de adultos e idosos, ambos praticantes de atividade física. MÉTODOS: Foram estudados 117 sujeitos praticantes de atividade física, com idade entre 40 e 80 anos. Para a caracterização da amostra, foram analisadas as variáveis idade, sexo, renda familiar e escolaridade. Para a comparação entre os grupos de adultos e idosos, foram analisadas as variáveis peso, estatura, índice de massa corporal, domínios e facetas da qualidade de vida (Whoqol-Bref). O teste de Kolmogorov-Smirnov foi aplicado para análise da normalidade e o teste de Mann-Whitney, para a comparação de medidas contínuas ou ordenáveis entre dois grupos independentes; adotou-se valor de p<0,05. RESULTADOS: Foram encontradas diferenças significantes para os domínios psicológico, relações sociais e qualidade de vida geral, sendo que os idosos apresentaram os maiores valores médios. CONCLUSÃO: Idosos ativos, comparados aos adultos ativos, percebem melhor qualidade de vida nos aspectos da vida ativa, do desempenho das atividades da vida diária, da aceitação da aparência física, satisfação financeira e disponibilidade de tempo para as atividades de lazer.

Professional competencies in primary health care for attending to older adults

Objective To identify and analyze the necessary competencies in primary health care for attending to older adults. Method An exploratory, descriptive, and quali-quantitative study was developed. Three rounds of the Delphi Technique were conducted with participants from primary health care services and a multidisciplinary committee. The first questionnaire asked participants to indicate the competencies needed for attending to older adults in primary health care. They were compiled into a list and added to a Likert Scale (from 1 to 5) for the second and third questionnaires. A consensus criterion of 70% was adopted. Results Twenty eight competencies were reached by consensus and were classified into twelve domains. Conclusion The competencies reflect Brazilian health care policy and constitute a reference for professional health practice and education when caring for the older adult in primary health care.

Health-related quality of life and psychological states in patients with pulmonary arterial hypertension

BACKGROUND

Pulmonary arterial hypertension (PAH) is a chronic illness that impairs physical function and leads to right-sided heart failure and premature death. There is limited knowledge on health-related quality of life (HRQOL) and psychological states in patients with PAH.

OBJECTIVE

The aim of this study was to determine the HRQOL and the psychological states of patients with PAH along with predictors of HRQOL.

METHODS

In a cross-sectional design, participants with PAH completed the Medical Outcomes Study Short Form-36 v2 to measure generic HRQOL, the US Cambridge Pulmonary Hypertension Outcome Review to measure disease-specific HRQOL, and the Profile of Mood States to measure the psychological states. Descriptive statistics were used to calculate all sociodemographic and clinical data and were expressed as means and standard deviations for continuous variables and as frequencies and proportions for dichotomous and nominal variables. The statistical significance level was set at P < 0.05. A multiple linear regression analysis was performed to examine the sociodemographic and clinical variables as predictors of HRQOL. A bivariate analysis of the sociodemographic and clinical variables was performed to determine correlates with HRQOL. The variables that correlated with HRQOL at the 0.20 level of significance were included.

RESULTS

There were 149 participants, 127 women and 22 men, with a mean age of 53.5 years. The participants demonstrated diminished general health, physical functioning, role physical, and vitality on the Short Form-36 v2. Functional class, education level, oxygen use, years since diagnosis, and calcium channel blocker therapy were predictive of poorer HRQOL.

CONCLUSIONS

Patients with PAH are experiencing diminished physical health and HRQOL. Future studies are needed to design and test interventions to improve HRQOL.

Quality of life of frail elderly users of the primary care

Objective Identifying the quality of life of frail elderly patients, users of primary care services. Methods A cross-sectional, quantitative study. The sample size was calculated based on the estimate of population proportion and consisted of 203 elderly. Data were collected by using a questionnaire of physical activity for the elderly, fatigue/exhaustion, quality of life, and by carrying out a test of gait speed, handgrip strength and anthropometric measurement. Results Among the 203 seniors, 39 were fragile. The mean scores for quality of life presented by the frail elderly were the following: 60.4 for pain, functional capacity 61.1, limitations due to physical aspects 71.1, general state of health 71.4, vitality 75, mental health 76.4, emotional aspects 81.1 and social aspects 85.6. Conclusion The dimensions of quality of life of the frail elderly that had lower mean scores were pain, functional capacity, limitations due to physical aspects and general state of health.

Quality of life data in older adults: self-assessment vs interview

BACKGROUND AND PURPOSE

There are obstacles for older people when reporting quality of life (QoL) in a survey format. The aim of this study was to explore the quality of data obtained on self-assessed QoL among older people with respect to modes of administration.

METHOD AND RESULTS

Approximately half of the QoL items showed significantly higher mean values in the mail sample than in the interview sample. Data suggest that there may be more vulnerability towards offering socially desirable answers. Problems with reduced energy and loss of memory affect both modes of administration.

CONCLUSIONS

This study demonstrates that investigating the mode of questionnaire administration among older people can be a valuable means by which to detect possible threats to data quality when interpreting QoL scores.

Avaliação da capacidade funcional dos idosos e fatores associados à incapacidade

O objetivo deste estudo foi avaliar a capacidade funcional e analisar as características associadas à incapacidade dos idosos atendidos em uma Estratégia da Saúde da Família em Montes Claros-MG. Utilizou-se a escala de Lawton e Brody e a escala de Katz, analisadas pela regressão logística multinomial. Foram entrevistados 286 idosos cuja idade variou de 60 a 103 anos, média de 71,2 anos (DP ± 8,3). Destes, 61,9% autorreferiram independentes quanto à capacidade funcional. A dependência apenas na AIVD foi positivamente associada à faixa etária ≥ 75 anos (OR = 8,38), ao sexo feminino (OR = 3,64) e com doença cardíaca (OR = 3,24). A dependência tanto nas AIVD como nas ABVD foi positivamente associada à faixa etária ≥ 75 anos (OR = 6,40), sem companheiro (OR = 3,26), aos que apresentavam AVE (OR = 51,85), doença cardíaca (OR = 4,18) e aos com diabetes (OR = 3,35). A maior proporção de idosos foi considerada independente para a realização de atividades básicas e instrumentais de vida diária. Contudo, uma parcela expressiva ainda apresenta comprometimento do estado funcional. É essencial que as equipes da Estratégia da Saúde da Família busquem a promoção da saúde e a prevenção de doenças, além de intervenções terapêuticas que possam minimizar os fatores que interferem na capacidade funcional.

Quality of life and related factors: a questionnaire survey of older people living alone in Mainland China

PURPOSE

There is a growing population of older people living alone within the context of dramatic population ageing and changing living arrangements. However, little is known about the quality of life (QoL) of older people living alone in Mainland China. This study aimed to investigate QoL and its related factors among Chinese older people who live alone.

METHODS

A stratified random cluster sample of 521 community-dwelling older people living alone in Shanghai completed a structured questionnaire through face-to-face interviews. QoL was measured using the Older People's Quality of Life Questionnaire. Other data collected included self-rated health, physical health, cognitive function, depression, functional ability, loneliness, social support, physical activity, health services satisfaction, satisfaction with overall dwelling conditions and socio-demographic variables.

RESULTS

Older people living alone in Mainland China rated social relationships and financial circumstances as sources of low satisfaction within their QoL. Multiway analysis of variance showed that satisfaction with overall dwelling conditions, self-rated health, functional ability, depression, economic level, social support, loneliness, previous occupation and health services satisfaction were independently related to QoL, accounting for 68.8% of the variance. Depression and previous occupation had an interaction effect upon QoL.

CONCLUSIONS

This study identified nine factors influencing the QoL of older people living alone in Mainland China. Interventions to increase satisfaction with dwelling conditions, improve economic level, social support and functional ability, decrease loneliness and depression and improve health services satisfaction appear to be important for enhancing their QoL.

Validade dimensional do instrumento de qualidade de vida WHOQOL-BREF aplicado a trabalhadores de saúde

O objetivo foi reavaliar a estrutura dimensional da versão brasileira do WHOQOL-BREF, consistência interna e validade fatorial convergente e discriminante. Estudo seccional em 386 trabalhadores de saúde. A análise fatorial confirmatória testou a estrutura do WHOQOL-BREF (24 e 26 itens) e a sugerida pela análise fatorial exploratória. Consistência interna foi aferida via confiabilidade composta; validade convergente e discriminante, pela variância média extraída e correlação entre fatores. O modelo de melhor ajuste foi o sugerido pela análise fatorial exploratória (26 itens) com seis fatores: quatro propostos teoricamente (geral, psicológico, relações sociais e meio ambiente) e dois pela subdivisão do domínio físico. Os itens "energia" e "segurança" (respectivamente, do físico e meio ambiente) foram remanejados para o psicológico. A confiabilidade composta foi boa (> 0,70), à exceção do fator geral. Validade convergente e discriminante foram adequadas para relações sociais e físico 2. Persistem controvérsias sobre a dimensionalidade do WHOQOL-BREF, particularmente sobre o domínio físico.

Quality of life of users of psychoactive substances, relatives, and non-users assessed using the WHOQOL-BREF

Quality of life is related to one of the basic human desires, which is to live well and feel good. The scope of this study was to evaluate the quality of life of psychoactive substance users and relatives, compared to non-users, analyzed by socioeconomic strata. A cross-sectional study with users of psychoactive substances, relatives, and other individuals who called the Information and Orientation Service regarding drug abuse. Data collection took place between November 2009 and December 2010. Data was collected from users, relatives, and non-users, including socioeconomic characteristics and data regarding substance consumption when appropriate. In addition to this the abbreviated version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was given to 347 individuals. Among the 138 users (70%) used alcohol, 76 (39%), marijuana, 111 (57%) tobacco, 78 (40%) cocaine and 70 (36%) crack. Control subjects had higher, scores than the relatives of users and users in all areas of the questionnaire (p < 0.05). Psychoactive substance users scored lower in almost all domains and overall score in the WHOQOL-BREF questionnaire in comparison with the sample of non-drug users. These findings reflect poor quality of life of patients and their relatives.

Condições de saúde e variáveis sociodemográficas associadas à qualidade de vida em idosas de um programa de atividade física de Curitiba, Paraná, Sul do Brasil

O presente estudo teve como objetivo analisar a associação entre variáveis sociodemográficas e condições de saúde com os domínios da qualidade de vida em idosas participantes do programa Idoso em Movimento. A amostra do estudo foi composta por 1.806 idosas, que foram avaliadas por meio de entrevista para os potenciais correlatos de qualidade de vida (WHOQOL-BREF e WHOQOL-OLD). O índice de massa corporal foi calculado após aferição do peso e da estatura. Os domínios da qualidade de vida foram classificados em tercis. Para análise dos dados, foi utilizada a regressão logística ordinal. Após ajustes para variáveis de confusão, a faixa etária, classe econômica, escolaridade, situação ocupacional e estado civil estiveram associados a alguns domínios da qualidade de vida (p < 0,05). Além disso, idosas obesas ou com problemas de saúde apresentaram menor razão de chance de estar nos escores mais elevados de qualidade de vida, e as idosas que usavam um ou dois medicamentos apresentaram maior razão de chance de estar nos escores mais elevados do domínio físico. Como conclusão, os fatores sociodemográficos e as condições de saúde estão associados com a qualidade de vida em idosas.

Explaining quality of life of older people in the Netherlands using a multidimensional assessment of frailty

PURPOSE

Although frailty was originally a medical concept, nowadays more and more researchers are convinced of its multidimensional nature, including a psychological and social domain of frailty as well as a physical domain. The objective of this study was to test the hypothesis that the prediction of quality of life by physical frailty components is improved by adding psychological and social frailty components.

METHODS

This cross-sectional study was carried out with a sample of Dutch citizens. A total of 1,031 people aged 65 years and older completed a Web-based questionnaire containing the Tilburg Frailty Indicator for measuring physical, psychological, and social frailty, and the WHOQOL-BREF for measuring four quality of life domains (physical health, psychological, social relations, environmental).

RESULTS

The findings show that the prediction of all quality of life domains by eight physical components of frailty was improved after adding four psychological and three social frailty components. The psychological frailty component 'feeling down' significantly improved the prediction of all four quality of life domains, after controlling for the effects of background characteristics and all other frailty components.

CONCLUSION

This study emphasizes the importance of a multidimensional assessment of frailty in the prediction of quality of life in older people.

Quality of life among older adults resident in long-stay care facilities

OBJECTIVES: to evaluate the older adults' perceptions of their quality of life (QoL) in two long-stay care facilities in Pouso Alegre and Santa Rita in Sapucaí, in the State of Minas Gerais, Brazil , and to identify the sociodemographic and health variables which interfere in this perception. METHOD: a cross-sectional epidemiological study of 77 older adults resident in institutions. The instruments used were: personal characterization; WHOQOL-bref and WHOQOL OLD. RESULT: the highest average obtained in the instruments was: the "Social Relationships" domain in the WHOQOL-bref (68%) and the "Sensory abilities" aspect in the WHOQOL-OLD (73.7%). The variables age, sex, physical activity and level of schooling have a significant correlation with the WHOQOL-bref and the variables sex and leisure have the same with the WHOQOL OLD. CONCLUSION: older adults who are younger, with higher levels of schooling and who undertake physical and leisure activity have, on average, better perceptions of their QoL. The older adults' QoL in this study had higher rates than that reported in the literature and was similar to that in the community. The results suggest the need to train those involved with older adults in institutions so that they may develop strategies which promote the adaptation, adjustment and maintenance of QoL.

Percepção de pessoas idosas sobre qualidade de vida

OBJETIVOS: Conhecer a percepção de idosos de um distrito de saúde de Porto Alegre/RS sobre o significado de qualidade de vida e identificar quais as facetas de qualidade de vida foram mais referidas pelos idosos. MÉTODOS: Estudo descritivo e transversal a partir de uma questão aberta: "O que significa QV para você?". Responderam a essa pergunta 260 idosos, moradores de Porto Alegre-RS. Foi realizada análise de conteúdo, com apoio do software NVivo 2.0, utilizando como categorias as facetas de QV propostas pela versão brasileira do instrumento WHOQOL-100 e módulo WHOQOL-OLD. RESULTADOS: Para a maioria, QV significava ter Saúde. Em seguida, as categorias mais representativas foram: sentimentos positivos, relações pessoais e alimentação. CONCLUSÕES: Os achados reforçam a idéia de que QV é um conceito multidimensional, podendo ser analisada tanto por parâmetros objetivos como subjetivos.