Skip to main content
Erschienen in: Quality of Life Research 4/2007

01.05.2007 | Original Paper

What drives older women’s perceptions of health-related quality of life?

verfasst von: Cara Tannenbaum, Sara Ahmed, Nancy Mayo

Erschienen in: Quality of Life Research | Ausgabe 4/2007

Einloggen, um Zugang zu erhalten

Abstract

Background

Age-related differences in the way ratings of health related quality of life (HRQL) are produced are poorly understood, especially for older women.

Objective

To examine age differences in critical dimensions of HRQL among older women using structural equation modelling. We hypothesized that physical, mental and social health domains would exert weaker total effects on HRQL among older middle-aged versus much older women.

Methods

A model of HRQL was developed and confirmatory factor analysis (CFA) was used to test the structure of the model across two samples of community-dwelling women aged 55 years and older. The relationships between the constructs and the relative magnitude of direct and indirect effects on HRQL were evaluated in a series of path models, with women younger and older than age 70 tested separately.

Results

The CFA model of HRQL showed excellent fit in both the national and verification samples (RMSEA 0.04 and 0.02 respectively). In the path model, the total effects of physical, mental and social health on general perceptions of HRQL were greater and more significant in middle-aged versus older women (beta coefficients 0.810, 0.277, 0.266, all P < 0.05 versus, 0.700, 0.189, and 0.057, P < 0.05 for physical and mental health only respectively).

Conclusion

This HRQL model suggests different opportunities for intervention among older women to improve the outcomes along the path to HRQL.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. The Journal of the American Medical Association, 273, 59–5.CrossRef Wilson, I. B., & Cleary, P. D. (1995). Linking clinical variables with health-related quality of life. The Journal of the American Medical Association, 273, 59–5.CrossRef
2.
Zurück zum Zitat Ustun, T. B., Chatterji, S., Bickenbach, J., Kostanjsek, N., & Schneider, M. (2003). The international classification of functioning, disability and health: A new tool for understanding disability and health. Disability and Rehabilitation, 25, 565–71.CrossRefPubMed Ustun, T. B., Chatterji, S., Bickenbach, J., Kostanjsek, N., & Schneider, M. (2003). The international classification of functioning, disability and health: A new tool for understanding disability and health. Disability and Rehabilitation, 25, 565–71.CrossRefPubMed
3.
Zurück zum Zitat International Classification of Functioning, Disability and Health. (2002). Beginner’s guide. Geneva: World Health Organization. International Classification of Functioning, Disability and Health. (2002). Beginner’s guide. Geneva: World Health Organization.
4.
Zurück zum Zitat Sullivan, M. D., Kempen, I. J. M., Van Sonderen, E., & Ormet, J. (2000). Models of quality of life in a population of community-dwelling Dutch elderly. Quality of Life Research, 9, 801–10CrossRefPubMed Sullivan, M. D., Kempen, I. J. M., Van Sonderen, E., & Ormet, J. (2000). Models of quality of life in a population of community-dwelling Dutch elderly. Quality of Life Research, 9, 801–10CrossRefPubMed
5.
Zurück zum Zitat Johnson, R. J., & Wolinsky, F. D. (1993). The structure of health status among older adults: Disease, disability, functional limitation, and perceived health. Journal of Health and Social Behavior, 34, 105–20.CrossRefPubMed Johnson, R. J., & Wolinsky, F. D. (1993). The structure of health status among older adults: Disease, disability, functional limitation, and perceived health. Journal of Health and Social Behavior, 34, 105–20.CrossRefPubMed
6.
Zurück zum Zitat Jans, L., & Stoddard, S. (1999). Chartbook on women and disability in the United States. An InfoUse Report. Washington, DC: U.S. National Institute on Disability and Rehabilitation Research. Jans, L., & Stoddard, S. (1999). Chartbook on women and disability in the United States. An InfoUse Report. Washington, DC: U.S. National Institute on Disability and Rehabilitation Research.
7.
Zurück zum Zitat Manton, G., Corder, L., & Stallard, E. (1997). Chronic disability trends in elderly United States populations: 1982–994. Proceedings of the National Academy of Sciences of the United States of America, 94, 2593–598.CrossRefPubMed Manton, G., Corder, L., & Stallard, E. (1997). Chronic disability trends in elderly United States populations: 1982–994. Proceedings of the National Academy of Sciences of the United States of America, 94, 2593–598.CrossRefPubMed
8.
Zurück zum Zitat Newman, A. B. (1999) Cognition and frailty in older women: Socioeconomic and physiologic influences. In R. B. Ness & L. H. Kuller (Eds.), Health and disease among women: Biological and environmental influences (pp. 86–11). New York: Oxford University Press. Newman, A. B. (1999) Cognition and frailty in older women: Socioeconomic and physiologic influences. In R. B. Ness & L. H. Kuller (Eds.), Health and disease among women: Biological and environmental influences (pp. 86–11). New York: Oxford University Press.
9.
Zurück zum Zitat Hopman, W. M., Towheed, T., Anastasssiades, T. et al. (2000). Canadian normative data for the SF-36 health survey. Canadian Medical Association Journal, 163, 265–71.PubMed Hopman, W. M., Towheed, T., Anastasssiades, T. et al. (2000). Canadian normative data for the SF-36 health survey. Canadian Medical Association Journal, 163, 265–71.PubMed
10.
Zurück zum Zitat Jenkinson, C., Stewart-Brown, S., Petersen, S., & Paice, C. (1999). Assessment of the SF-36 version 2 in the United Kingdom. Journal of Epidemiology and Community Health, 53, 45–0.CrossRef Jenkinson, C., Stewart-Brown, S., Petersen, S., & Paice, C. (1999). Assessment of the SF-36 version 2 in the United Kingdom. Journal of Epidemiology and Community Health, 53, 45–0.CrossRef
11.
Zurück zum Zitat Ware, J. E. Jr., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 manual and interpretation guide. Boston: The Health Institute, New England Medical Center. Ware, J. E. Jr., Snow, K. K., Kosinski, M., & Gandek, B. (1993). SF-36 manual and interpretation guide. Boston: The Health Institute, New England Medical Center.
12.
Zurück zum Zitat Sullivan, M., & Karlsson, J. (1998). The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: Results from normative population. Journal of Clinical Epidemiology, 51, 1105–3.CrossRefPubMed Sullivan, M., & Karlsson, J. (1998). The Swedish SF-36 Health Survey III. Evaluation of criterion-based validity: Results from normative population. Journal of Clinical Epidemiology, 51, 1105–3.CrossRefPubMed
13.
Zurück zum Zitat Aaronson, N. K., Muller, M., Cohen, P. D. A., Essink-Bot, M. L., Fekkes, M., Sanderman, R. et al. (1989). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinical Epidemiology, 51, 1055–068.CrossRef Aaronson, N. K., Muller, M., Cohen, P. D. A., Essink-Bot, M. L., Fekkes, M., Sanderman, R. et al. (1989). Translation, validation, and norming of the Dutch language version of the SF-36 Health Survey in community and chronic disease populations. Journal of Clinical Epidemiology, 51, 1055–068.CrossRef
14.
Zurück zum Zitat Idler, E. L. (2003). Discussion: Gender differences in self-rated health in mortality and in the relationship between the two. The Gerontologist, 43, 372–75. Idler, E. L. (2003). Discussion: Gender differences in self-rated health in mortality and in the relationship between the two. The Gerontologist, 43, 372–75.
15.
Zurück zum Zitat Lee, Y. (2000). The predictive value of self assessed general physical and mental health on functional decline and mortality in older adults. Journal of Epidemiology and Community Health, 54, 123–29.CrossRefPubMed Lee, Y. (2000). The predictive value of self assessed general physical and mental health on functional decline and mortality in older adults. Journal of Epidemiology and Community Health, 54, 123–29.CrossRefPubMed
16.
Zurück zum Zitat Idler, E., & Binyamini Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–7.CrossRefPubMed Idler, E., & Binyamini Y. (1997). Self-rated health and mortality: A review of twenty-seven community studies. Journal of Health and Social Behavior, 38, 21–7.CrossRefPubMed
17.
Zurück zum Zitat Helmer, C., Barberger-Gateau, P., Letenneur, L., & Dartigues, J. F. (1999). Subjective health and mortality in French elderly women and men. The Journals of Gerontology. Series B. Psychological Sciences and Social Sciences, 54, S84–S92. Helmer, C., Barberger-Gateau, P., Letenneur, L., & Dartigues, J. F. (1999). Subjective health and mortality in French elderly women and men. The Journals of Gerontology. Series B. Psychological Sciences and Social Sciences, 54, S84–S92.
18.
Zurück zum Zitat Deeg, D. J. H., & Kriegsman, D. M. W. (2003). Concepts of self-rated health: Specifying the gender difference in mortality risk. The Gerontologist, 43, 376–86.PubMed Deeg, D. J. H., & Kriegsman, D. M. W. (2003). Concepts of self-rated health: Specifying the gender difference in mortality risk. The Gerontologist, 43, 376–86.PubMed
19.
Zurück zum Zitat Power, C., Matthews, S., & Manor, O. (1998). Ineqalities in self-rated health: Explanations from different stages of life. Lancet, 351, 1009–014.CrossRefPubMed Power, C., Matthews, S., & Manor, O. (1998). Ineqalities in self-rated health: Explanations from different stages of life. Lancet, 351, 1009–014.CrossRefPubMed
20.
Zurück zum Zitat Baltes, P. B., Staudinger, U. M., & Lindenberger, U. (1999). Lifespan psychology: Theory and application to intellectual functioning. Annual Review of Psychology, 50, 471–07.CrossRefPubMed Baltes, P. B., Staudinger, U. M., & Lindenberger, U. (1999). Lifespan psychology: Theory and application to intellectual functioning. Annual Review of Psychology, 50, 471–07.CrossRefPubMed
21.
Zurück zum Zitat Rothermund, K., & Brandtstadter, J. (2003). Coping with deficits and losses in later life: From compensatory action to accommodation. Psychology and Aging, 18, 896–05.CrossRefPubMed Rothermund, K., & Brandtstadter, J. (2003). Coping with deficits and losses in later life: From compensatory action to accommodation. Psychology and Aging, 18, 896–05.CrossRefPubMed
22.
Zurück zum Zitat Turk-Charles, S., Mather, M., & Carstensen, L. L. (2003). Aging and emotional memory: The forgettable nature of negative images for older adults. Journal of Experimental Psychology, 132, 310–24. Turk-Charles, S., Mather, M., & Carstensen, L. L. (2003). Aging and emotional memory: The forgettable nature of negative images for older adults. Journal of Experimental Psychology, 132, 310–24.
23.
Zurück zum Zitat Heckhausen, J., & Brim, O. G. (1997). Perceived problems for self and others: Self-protection by social downgrading throughout adulthood. Psychology and Aging, 12, 610–19.CrossRefPubMed Heckhausen, J., & Brim, O. G. (1997). Perceived problems for self and others: Self-protection by social downgrading throughout adulthood. Psychology and Aging, 12, 610–19.CrossRefPubMed
24.
Zurück zum Zitat Tannenbaum, C., Mayo, N., & Ducharme, F. (2005). Older women’s health priorities and perceptions of care delivery: Results of the WOW health survey. Canadian Medical Association Journal, 173, 153–59.CrossRefPubMed Tannenbaum, C., Mayo, N., & Ducharme, F. (2005). Older women’s health priorities and perceptions of care delivery: Results of the WOW health survey. Canadian Medical Association Journal, 173, 153–59.CrossRefPubMed
25.
Zurück zum Zitat Tannenbaum, C., & Mayo, N. (2003). Women’s health priorities and perceptions of care: A survey to identify opportunities for improving preventative health care delivery for older women. Age Ageing, 32, 626–35.CrossRefPubMed Tannenbaum, C., & Mayo, N. (2003). Women’s health priorities and perceptions of care: A survey to identify opportunities for improving preventative health care delivery for older women. Age Ageing, 32, 626–35.CrossRefPubMed
26.
Zurück zum Zitat Madden, R., Choi C., & Sykes C. (2003). The ICF as a framework for national data: The introduction of ICF into Australian data dictionaries. Disability and Rehabilitation, 25, 676–82.CrossRefPubMed Madden, R., Choi C., & Sykes C. (2003). The ICF as a framework for national data: The introduction of ICF into Australian data dictionaries. Disability and Rehabilitation, 25, 676–82.CrossRefPubMed
27.
Zurück zum Zitat Cieza, A., Brockow, T., Ewert, T., Amman, E., Kollerits, B., Chatterji, S., Ustun, T. B., & Stucki, G. (2002). Linking health-status measurements to the international classification of functioning, disability and health. Journal of Rehabilitation Medicine, 34, 205–10.CrossRefPubMed Cieza, A., Brockow, T., Ewert, T., Amman, E., Kollerits, B., Chatterji, S., Ustun, T. B., & Stucki, G. (2002). Linking health-status measurements to the international classification of functioning, disability and health. Journal of Rehabilitation Medicine, 34, 205–10.CrossRefPubMed
28.
Zurück zum Zitat Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–33.CrossRefPubMed Ware, J. E., Kosinski, M., & Keller, S. D. (1996). A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–33.CrossRefPubMed
29.
Zurück zum Zitat Mayo, N. E., Goldberg, M., & Kind, P. (1997). Performance of the Euroqol EQ-5D in a Canadian population. Discussion paper, EuroQol plenary meeting Rotterdam, 2– October 1997. Mayo, N. E., Goldberg, M., & Kind, P. (1997). Performance of the Euroqol EQ-5D in a Canadian population. Discussion paper, EuroQol plenary meeting Rotterdam, 2– October 1997.
30.
Zurück zum Zitat Kind, P. (1996). The EurolQol Instrument: An index of health-related quality of life. In Quality of life and pharmacoeconomics in clinical trials. Ed: Spilker B. Lippincott-Raven. Kind, P. (1996). The EurolQol Instrument: An index of health-related quality of life. In Quality of life and pharmacoeconomics in clinical trials. Ed: Spilker B. Lippincott-Raven.
31.
Zurück zum Zitat Keller, S. D., Ware, J. E., Bentler, P. M., Aaronson, N. K., Alonso, J., Apolone, G., et al. (1998). Use of structural equation modeling to test the construct validity of the SF-36 health survey in ten countries: Results from the IQOLA Project. Clinical Epidemiology, 51, 1179–188.CrossRef Keller, S. D., Ware, J. E., Bentler, P. M., Aaronson, N. K., Alonso, J., Apolone, G., et al. (1998). Use of structural equation modeling to test the construct validity of the SF-36 health survey in ten countries: Results from the IQOLA Project. Clinical Epidemiology, 51, 1179–188.CrossRef
32.
Zurück zum Zitat Wood-Dauphinee, S. L., Opzoomer, M. A., Williams, J. I., Marchand, B., & Spitzer, W.O. (1988). Assessment of global function: The reintegration to normal living index. Archives of Physical Medicine and Rehabilitation, 69, 83–90.PubMed Wood-Dauphinee, S. L., Opzoomer, M. A., Williams, J. I., Marchand, B., & Spitzer, W.O. (1988). Assessment of global function: The reintegration to normal living index. Archives of Physical Medicine and Rehabilitation, 69, 83–90.PubMed
33.
Zurück zum Zitat Wood-Dauphinee, S., & Williams, J. I. (1987). Reintegration to normal living as a proxy to quality of life. Journal of Chronic Diseases, 40, 491–99.CrossRefPubMed Wood-Dauphinee, S., & Williams, J. I. (1987). Reintegration to normal living as a proxy to quality of life. Journal of Chronic Diseases, 40, 491–99.CrossRefPubMed
34.
Zurück zum Zitat Finch, E., Brooks, D., Stratford, P. W., & Mayo, N. E. (Eds). (2002). Physical rehabilitation outcome measures: A guide to enhanced clinical decision making (2nd ed.). Canadian Physiotherapy Association. Finch, E., Brooks, D., Stratford, P. W., & Mayo, N. E. (Eds). (2002). Physical rehabilitation outcome measures: A guide to enhanced clinical decision making (2nd ed.). Canadian Physiotherapy Association.
35.
Zurück zum Zitat Keller, H. H., Hedley, M. R., & Wong Brownlee, S. (2000). The development of seniors in the community: Risk evaluation for eating and nutrition (SCREEN). Canadian Journal of Dietetic Practice and Research, 61, 67–2.PubMed Keller, H. H., Hedley, M. R., & Wong Brownlee, S. (2000). The development of seniors in the community: Risk evaluation for eating and nutrition (SCREEN). Canadian Journal of Dietetic Practice and Research, 61, 67–2.PubMed
36.
Zurück zum Zitat Keller, H. H., McKenzie, J. D., & Goy, R. E. (2001). Construct validation and test-retest reliability of the seniors in the community: Risk evaluation for eating and nutrition questionnaire. The Journals of Gerontology. Series A. Biological Sciences and Medical Sciences, 56A, M552–M558. Keller, H. H., McKenzie, J. D., & Goy, R. E. (2001). Construct validation and test-retest reliability of the seniors in the community: Risk evaluation for eating and nutrition questionnaire. The Journals of Gerontology. Series A. Biological Sciences and Medical Sciences, 56A, M552–M558.
37.
Zurück zum Zitat Kline, R. B. (1998). Principles and practice of structural equation modeling. New York: The Guilford Press. Kline, R. B. (1998). Principles and practice of structural equation modeling. New York: The Guilford Press.
38.
Zurück zum Zitat Hayduk L. A. (1987). Structural equation modeling with LISREL: Essentials and advances. Baltimore: Johns Hopkins University Press. Hayduk L. A. (1987). Structural equation modeling with LISREL: Essentials and advances. Baltimore: Johns Hopkins University Press.
39.
Zurück zum Zitat Hoyle, R. H. (1995). Structural equation modeling : Concepts, issues, and application. Thousand Oaks: Sage Publications. Hoyle, R. H. (1995). Structural equation modeling : Concepts, issues, and application. Thousand Oaks: Sage Publications.
40.
Zurück zum Zitat Kaplan, D. (1955). Structural equation modeling : Foundations and extensions. Thosand Oaks, CA: Sage Publications. Kaplan, D. (1955). Structural equation modeling : Foundations and extensions. Thosand Oaks, CA: Sage Publications.
41.
Zurück zum Zitat Bollen K. A. (1989). Structural equations with latent variables. New York: Wiley. Bollen K. A. (1989). Structural equations with latent variables. New York: Wiley.
42.
Zurück zum Zitat Brown, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural models. Newbury Park: Sage Publications. Brown, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural models. Newbury Park: Sage Publications.
43.
Zurück zum Zitat Hu, L.-T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventionals criteria versus new alternatives. Stuctural Equation Modeling, 6, 1–5.CrossRef Hu, L.-T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventionals criteria versus new alternatives. Stuctural Equation Modeling, 6, 1–5.CrossRef
44.
Zurück zum Zitat Jöreskog K. G., & Sörbom D. (1996). LISREL 8 user’s reference guide. Illinois: Scientific Software International Inc. Jöreskog K. G., & Sörbom D. (1996). LISREL 8 user’s reference guide. Illinois: Scientific Software International Inc.
45.
Zurück zum Zitat Johnson, R. J., & Wolinsky, F. D. (1994). Gender, race, and health: The structure of health status among older adults. The Gerontologist, 34, 24–5.PubMed Johnson, R. J., & Wolinsky, F. D. (1994). Gender, race, and health: The structure of health status among older adults. The Gerontologist, 34, 24–5.PubMed
46.
Zurück zum Zitat Fylkesnes, K., & Forde, O. H. (1992). Determinants and dimensions involved in self-evaluation of health. Social Science and Medicine, 35, 271–79.CrossRefPubMed Fylkesnes, K., & Forde, O. H. (1992). Determinants and dimensions involved in self-evaluation of health. Social Science and Medicine, 35, 271–79.CrossRefPubMed
47.
Zurück zum Zitat Fayers, P. M. (2004). Quality-of-life measurement in clinical trials–the impact of causal variables. Journal of Biopharmaceutical Statistics, 14, 155–76.CrossRefPubMed Fayers, P. M. (2004). Quality-of-life measurement in clinical trials–the impact of causal variables. Journal of Biopharmaceutical Statistics, 14, 155–76.CrossRefPubMed
Metadaten
Titel
What drives older women’s perceptions of health-related quality of life?
verfasst von
Cara Tannenbaum
Sara Ahmed
Nancy Mayo
Publikationsdatum
01.05.2007
Verlag
Springer Netherlands
Erschienen in
Quality of Life Research / Ausgabe 4/2007
Print ISSN: 0962-9343
Elektronische ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-006-9148-2

Weitere Artikel der Ausgabe 4/2007

Quality of Life Research 4/2007 Zur Ausgabe