An Integrated Conceptual Model of Quality of Life for Older Adults Based on a Synthesis of the Literature

Quality of life is fast becoming a standard of measure of long-term care and gerontological service outcomes. Although the issue of quality of life has been of increasing interest in the field of aging, there has been little agreement as to the clarity and definition of the concept and how to measure it, especially as it relates to older adults. Presented here is a comprehensive, integrated model of quality of life that was developed by synthesizing existing constructs within the literature into six major life domains—(1) social well-being, (2) physical well-being, (3) psychological well-being, (4) cognitive well-being, (5) spiritual well-being, and (6) environmental well-being. Consistent with a general systems framework, this holistic model expands the predominant Health-Related Quality of Life constructs to incorporate non-physical aspects of well-being. Each of these domains was broken down into several dimensions in an effort to operationalize the concept of quality of life so that it can have some common standard of useful measurement. These major life domains and indicators are important factors in determining the perceptions of quality of life of older adults. Understanding what constitutes quality of life and how to measure it comprehensively has significant implications for social policy and practice in the field of aging.     

Developing and Validating a Measure of Consumer Well-Being in Relation to Cell Phone Use

This paper reports on an effort to develop a consumer well-being measure in relation to cell phone use. The measure is based on the theoretical notion that the perception of the overall quality-of-life impact of the cell phone on users is determined by their perceptions of the impact of the cell phone in various life domains such as social life, leisure life, family life, education life, health and safety, love life, work life, and financial life. In turn, the perception of impact of the cell phone in a given life domain (e.g., social life, leisure life) is determined by perceptions of benefits and costs of the cell phone within that domain. We conducted two major studies to select items capturing perceived benefits and costs that are predictive of perceived quality-of-life impact of the cell phone.     

老年人的智慧

智慧是个体在其人生经历中习得的一种德才一体的综合心理素质, 是成功老龄化的重要标志和毕生发展的理想终点。研究发现, 三维智慧量表、自我评估智慧量表、成人自我超越问卷等自陈式测量和柏林智慧范式、智慧推理等表现式测量对老年人智慧评估具有良好性能; 老年人智慧发展受到开放性、自我反思、情绪调节、人格成长等内在因素以及受教育程度、关键生活经历、社会环境等外在因素的交互影响; 毕生发展的智慧为老年人带来更高主观幸福感、生活满意度以及更少社会疏离感、孤独感和抑郁。未来应该开发多测度、整合的老年人智慧测评工具; 深入揭示老年人智慧的预测因素、影响后效及其内部作用机制; 进一步探索社区养老服务中老年人智慧的干预与培育策略。     

Comparative risk and perceived control: implications for psychological and physical well-being among older adults

As older adults become more susceptible to certain health crises, their preoccupation with their risk of suffering such events increases. Understanding the implications of risk perceptions is critical because they may have consequences for psychological and physical well-being in later life. In the present study of older adults living in the community, the authors examined participants' comparative risk estimates (CREs)--their perceptions of their own risk relative to a similar other's risk--of suffering a hip fracture. Using multiple regression analyses, the authors examined the role of CREs on psychological well-being (negative emotions, life satisfaction) and self-rated physical well-being (general physical health, recent physical health). The authors expected perceived control (PC) to moderate the relationship between CREs and well-being. The predicted interaction did occur: Among individuals with high PC, comparative optimism (perceiving a comparatively low risk) was associated with better psychological well-being (fewer negative emotions and greater life satisfaction) and better physical well-being (general and recent physical health) relative to comparative pessimism (perceiving a comparatively high risk). Among individuals with low PC, there were no differences in well-being between comparative optimists and comparative pessimists. These findings suggest that the protective effect of comparative optimism on well-being is limited to older adults who have a strong sense of control.     

The chronic illness quality of life (CIQOL) model: explaining life satisfaction in people living with HIV disease.

The chronic illness quality of life (CIQOL) model theorizes that life satisfaction in persons living with a chronic illness such as HIV disease is a function of illness-related discrimination, barriers to health care and social services, physical well-being, social support, and coping. The CIQOL model was evaluated using data from 275 persons living with HIV disease. Women reported less life satisfaction and confronted more barriers to health care and social services than men, and White participants reported higher perceptions of AIDS-related discrimination than non-White participants. The CIQOL model provided an excellent fit to study data (root-mean-square error of approximation = .03) and accounted for almost a third of the variance in life satisfaction scores. Barriers to health care and social services played a particularly prominent role in the model.     

Altruism and health outcomes in multiple sclerosis: The effect of cognitive reserve

Despite age-associated decreases in cognitive and physical abilities, age is not associated with a decrease in ratings of well-being; this phenomenon is termed the ‘paradox of well-being.’ One potential explanation for this paradox may be that older adults place less value on cognitive abilities that have been shown to decrease with age (e.g., memory) and more value on cognitive abilities shown to increase with age (e.g., knowledge). Using online methods, 358 individuals between the ages of 18 and 88 completed a survey assessing the values placed on everyday cognitive abilities, self-ratings for those same abilities, and life satisfaction. Results indicated that there were minimal age-related differences in values placed on everyday cognitive abilities and that values generally did not moderate the relationship between perceptions of cognitive functioning and life satisfaction. Of note, values placed on cognition significantly predicted life satisfaction in younger adults, but not in middle-aged and older adults.     

How solitude relates to well-being in old age: A review of inter-individual differences

Older adults are more likely to live alone and engage in solitary activities than young adults, leading to decrement in their well-being. However, researchers have discovered beneficial implications of solitude, and some of them even have established that the negative and positive effects of solitude coexist. The study's purposes are to investigate the relationship between solitude and well-being among older adults and to further examine the inter-individual differences in this relationship. In the database of Google Scholar, the systematic review methods are used and 17 articles meet the inclusion criteria. The study concludes that older adults experience solitude both negatively and positively; the complex relationship between solitude and well-being can be better understood and explained by inter-individual differences based on intrapersonal, interpersonal, and cultural factors. This systematic review adopts a perspective that spans individual and social/cultural levels and helps grasp the link between solitude and well-being in older adults. Based on this review, the researcher can develop appropriate interventions to help older people maximize the benefits of solitude while minimizing the drawbacks to further achieve a higher quality of life.     

Regret and quality of life across the adult life span: the influence of disengagement and available future goals

Two studies examined the associations between life regrets and indicators of quality of life across the adult life span. Given that opportunities to undo regrets decline with age, regret intensity was expected to be inversely associated with subjective well-being and health among older adults. In addition, the research explored protective factors that have the potential to reduce older adults' regret intensity. It was suggested that being disengaged from undoing the consequences of regrets and having many future goals available may reduce older adults' intensity of regret and thereby contribute to a better quality of life. Across both studies, the findings demonstrate that older adults perceived reduced opportunities to undo the consequences of their regrets and that regret intensity predicted a reduced quality of life only among older adults. Furthermore, the findings support the adaptive value of disengagement and available future goals for managing life regrets in older adults.     

Quality of life of adults with mental retardation/developmental disabilities who live with family

In this paper, we review the literature related to the quality of life of adults with mental retardation/developmental disabilities (MR/DD) who live at home with their families. We examine the nature of the relationships between adults with MR/DD and their parents and siblings, the social worlds of adults with MR/DD, age-related functional and health issues that affect their quality of life, the range of services and supports provided to them, and familial efforts to plan for their continued well-being when parental care is no longer viable. Individual characteristics associated with these dimensions and/or more compromised quality of life profiles are identified. The paper concludes with recommendations for expanded research on the quality of life of adults with MR/DD who live in the parental home, a topic which has received markedly less attention than the quality of life of adults who live in publicly supported residential settings. MRDD Research Reviews 7:105-114, 2001.     

Correlates of spirituality and well-being in a community sample of people living with HIV disease

While the past several years have witnessed an increase in the amount of research examining the spiritual perspectives of people living with HIV/AIDS, this literature is still insufficient to guide the conceptualization and development of spiritually based interventions to improve the life quality of people living with HIV illness. The present study assessed a community sample of 275 persons living with HIV disease to examine relationships among their spirituality, quality of life, perceptions of social support, and coping and adjustment efforts. This study found relationships between social support, active problem solving, life satisfaction, and gender and race with higher levels of spirituality among people living with HIV/AIDS. Mental health providers may need to routinely include assessments of spirituality and religious practices. Caregivers, faith communities, and mental health providers will need to assist in developing supportive environments that enhance the spiritual life and social well-being of people living with HIV infection. Additionally, caregiver training programs will need to focus on spiritual practices as a means of establishing a support system that increases the psychosocial well-being of people living with HIV/AIDS.     

The importance of including quality-of-life indices in international social and economic development activities

Psychology has not been a visible player in international social and economic development efforts. Through its demonstrated commitment to the concept of quality of life, psychology has an opportunity to help shape foreign policy and to improve the lives of countless people around the globe. Poverty has reached unacceptable limits of humanitarian tolerance and political consequence throughout the world. The United Nations estimates that 20% of the world's population now lives in conditions of absolute poverty in which there is an absence of even the bare essentials for living. Social and economic development efforts have often failed despite good intentions because they have often concentrated on improving peoples' material level of living but not their quality of life. This article addresses the need to include quality-of-life (QOL) indices in international social and economic development efforts. In addition, the article calls attention to the need to use valid cross-cultural measurement strategies (i.e., culturally equivalent) when assessing QOL across cultural and national boundaries. Current approaches to social and economic development rely heavily on interventions that do not reflect the actual peoples' perceptions of life satisfaction and subjective well-being. Self-serving political and economic national interests have kept new approaches to development from being implemented. New interventions must be holistic, decentralized, integrated, empowering, participatory, and human-resource directed, and must include culturally equivalent objective and subjective quality-of-life indices as the arbiters of success.     

Age stereotypes,flexible goal adjustment,and well-being among Chinese older adults

Previous studies have examined the independent roles of positive age stereotypes (PAS) and negative age stereotypes (NAS) in successful aging. This study aimed to examine the joint effect of PAS and NAS on the well-being of Chinese older adults, and to further examine whether this effect was moderated by flexible goal adjustment (FGA). Using a cross-sectional design, 279 Chinese older adults (age range 60?97 years) completed measures related to age stereotypes, FGA, and well-being. The results showed that PAS interacted with NAS to predict well-being. In addition, the joint effect of PAS and NAS was moderated by FGA. Specially, for older adults with low FGA, NAS weakened the positive association between PAS and well-being; whereas, for older adults with high FGA, NAS could not influence the association between PAS and well-being. Tailored interventions to modify aging perceptions and to enhance coping flexibility competence might be helpful for promoting the well-being of older adults.     

Dealing with negative social exchanges in later life: coping responses, goals, and effectiveness

Negative exchanges have been shown to detract from psychological well-being in later life, but little research has investigated how older adults respond to such exchanges. The authors examined older adults' coping responses, goals, and effectiveness following a specific negative social exchange. The findings revealed that participants' coping responses and the effectiveness of these responses varied as a function of their coping goals. The results underscore the importance of considering older adults' coping responses and goals when evaluating factors that affect the impact of negative social exchanges on well-being in later life.     

Perceptions and implications of received spousal care: evidence from the Caregiver Health Effects Study

The experiences of older care recipients have received far less theoretical and empirical attention than those of their family caregivers. In this study of 91 care recipients, the authors assessed perceptions of the amount, timing, and manner of spousal assistance; the amount of strain experienced from receiving care; and psychological well-being. Although female care recipients were more likely to report dissatisfaction with the manner in which assistance was provided, there were few gender differences in perceptions of care overall. In a stringent test of the hypothesis that perceived quality of spousal care affects recipient well-being, the authors found that poorer quality of care was related to increased depressive symptoms and a decreased sense of mastery 1 year later. These longitudinal effects were independent of the recipient's physical disability, marital quality, and care-receiving strain as well as the caregiver's well-being. These findings argue for a comprehensive assessment of the care-receiving experience that includes both care-recipient and caregiver perspectives.     

Subjective well-being evaluations among older black Americans

The causal relations among social status and resource, health, and stress factors, and a single-item measure of subjective well-being (i.e., happiness) were examined among a national sample of 581 Black adults aged 55 years and over. Results indicated that although social status and resource factors had a limited impact on happiness ratings, these measures were important in predicting intermediate factors related to health status and satisfaction and stress. Happiness was directly influenced by stress and reported satisfaction with health, whereas the effect of health disability was mediated by stress and health satisfaction. The findings suggest that certain groups of older Blacks (i.e., relatively younger, widowed, and separated) may be at specific risk for diminished well-being. However, adverse health and life conditions, which are determined by status and resources, represent circumstances that further jeopardize the well-being of older Black adults.     

Mental Illness and Mental Health: The Two Continua Model Across the Lifespan

Mental health has long been defined as the absence of psychopathologies, such as depression and anxiety. The absence of mental illness, however, is a minimal outcome from a psychological perspective on lifespan development. This article therefore focuses on mental illness as well as on three core components of positive mental health: feelings of happiness and satisfaction with life (emotional well-being), positive individual functioning in terms of self-realization (psychological well-being), and positive societal functioning in terms of being of social value (social well-being). The two continua model holds that mental illness and mental health are related but distinct dimensions. This model was studied on the basis of a cross-sectional representative internet survey of Dutch adults (N = 1,340; 18–87 years). Mental illness was measured with the Brief Symptom Inventory and mental health with the Mental Health Continuum Short Form. It was found that older adults, except for the oldest-old, scored lower on psychopathological symptoms and were less likely to be mentally ill than younger adults. Although there were fewer age differences for mental health, older adults experienced more emotional, similar social and slightly lower psychological well-being. In sum, today’s older adults have fewer mental illness problems, but they are not in a better positive mental health than today’s younger adults. These findings support the validity of the two continua model in adult development.     

Monitoring Perceptions of Social Progress and Pride of Place in a South African Community

A social indicators community project was conducted in 2007 to monitor living standards and quality of life in Rhini, a low-income suburb of Grahamstown, Makana Municipality, South Africa. Since 1994, under democratic rule, considerable progress has been made in service delivery to the formerly disadvantaged in South African society in terms of access to housing, infrastructure, and a social safety net to mitigate the high rate of unemployment. A representative cross-sectional household study (n 1020) conducted in 2007 in Rhini found that a positive assessment of the household’s situation and personal life satisfaction did not reflect better living conditions. Lack of income and employment opportunities appeared to dilute gains from higher living standards. The project also inquired into attitudes to place names and a proposed name change for the city under discussion at the time of the survey. It is argued that a place name with which one can identify may be as important as service delivery to enhance community satisfaction and overall quality of life. Dissatisfied residents who had limited access to services and expressed less civic pride were more likely than others to opt for a proposed name change for the city of Grahamstown that would better reflect the country’s new identity and multicultural heritage. It is concluded that a useful pursuit for community quality-of-life studies in countries undergoing social transformation will be to inquire into the complex combination of factors that drive perceptions of material and symbolic progress.     

Older adults’ perceptions of ageing and their health and functioning: a systematic review of observational studies

Many older people perceive ageing negatively, describing it in terms of poor or declining health and functioning. These perceptions may be related to older adults’ health. The aim of this review was to synthesise existing research on the relationship between older adults’ perceptions of ageing and their health and functioning. A systematic search was conducted of five electronic databases (ASSIA, CINAHL, IBSS, MEDLINE and PsycINFO). Citations within identified reports were also searched. Observational studies were included if they included perceptions of ageing and health-related measures involving participants aged 60 years and older. Study selection, data extraction and quality appraisal were conducted using predefined criteria. Twenty-eight reports met the criteria for inclusion. Older adults’ perceptions of ageing were assessed with a variety of measures. Perceptions were related to health and functioning across seven health domains: memory and cognitive performance, physical and physiological performance, medical conditions and outcomes, disability, care-seeking, self-rated health, quality of life and death. How ageing is perceived by older adults is related to their health and functioning in multiple domains. However, higher quality and longitudinal studies are needed to further investigate this relationship.     

Psychological parameters to understand and manage the NIMBY effect

Decision making in environmental intervention and management usually displeases someone. Public administration entities and private organisations must pinpoint and manage certain environmental and social services that though deemed necessary and essential, often carry a negative image that creates social rejection. This is known as the NIMBY effect (Not In My Backyard). This phenomenon, which to a certain extent can be considered normal, is related to social perception of risk, to the complex process of attribution of causes, and to perceived inequity. It addresses the issue of life quality in terms of the potential alteration of people's well-being that generates self-defence behaviour. This paper reviews previous literature, analyses and compares the most relevant environmental conflicts in Catalonia between 1988 and 2003, and shows that not every conflict should be considered a NIMBY effect. It then suggests some management recommendations for NIMBY conflict management from the standpoint of classical social psychology theories.     

Emergent Values and the Experience of Aging

This study examined the role of values or guiding principles emerging from the life histories and reflections of 111 older adults as predictors of the experience of aging. Participants completed a detailed life history interview in which they described themselves on 10 major life dimensions. They also completed standardized questionnaires of well-being, personality traits, and intolerance of uncertainty. Participants expressed a mix of prosocial and self-interest values in their interviews. Multiple regression analyses indicated that social support and intolerance of uncertainty positively predicted the extent of values articulated in the interviews. Better quality of aging was predicted positively by extent of emergent values and greater well-being and negatively by age. The results indicate that an examination of values provides a unique contribution to the understanding of the experience of aging.