Carmel Sara
a Center for Multidisciplinary Research in Aging, and Department of Public Health, Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.
Aging Ment Health. 2017 Mar;21(3):289-296. doi: 10.1080/13607863.2015.1081149. Epub 2015 Sep 1.
In old age, the will-to-live (WTL) is one of the most important indicators of subjective well-being (SWB). However, few studies to date have focused on WTL. In these studies, WTL has mainly been evaluated via indirect questions concerning factors that may influence peoples' WTL, or by measures directed to patients with specific diseases. The current study describes the development and psychometric properties of a new WTL scale.
The five-item WTL scale was developed on the basis of previous qualitative and quantitative research, and was evaluated in a longitudinal study of a random sample of 868 adults, aged 75+.
Confirmatory factor analytic (CFA) models were computed showing that each of the five items contributed significantly to measurement of a single WTL latent factor. Goodness-of-fit statistics were in ideal parameters for these CFA models at each point of data collection. Moreover, temporal analyses indicated that the relative contribution to measurement for each item was equivalent across time, attesting to reliability of measurement and the construct validity of WTL measurement. Concurrent validity was supported by significant positive correlations between WTL and life satisfaction, happiness, self-rated health, morale, self-rated aging, and, as expected, by inverse associations of WTL with depression and loneliness.
The results of these analyses indicate that the WTL scale is a valid and reliable instrument. Considering the importance of the WTL concept in late life, and the psychometric properties of the WTL scale, we recommend it for use in research and practice related to older adults' SWB and end-of-life care.
在老年群体中，生存意愿（WTL）是主观幸福感（SWB）最重要的指标之一。然而，迄今为止很少有研究关注生存意愿。在这些研究中，生存意愿主要通过与可能影响人们生存意愿的因素相关的间接问题进行评估，或者通过针对特定疾病患者的测量方法来评估。本研究描述了一种新的生存意愿量表的开发及其心理测量特性。
基于先前的定性和定量研究开发了包含五个条目的生存意愿量表，并在一项对868名75岁及以上成年人的随机样本的纵向研究中进行了评估。
计算了验证性因素分析（CFA）模型，结果显示五个条目中的每一个都对单一生存意愿潜在因素的测量有显著贡献。在数据收集的每个时间点，这些CFA模型的拟合优度统计量都处于理想参数范围内。此外，时间分析表明，各条目对测量的相对贡献在不同时间是等效的，这证明了测量的可靠性以及生存意愿测量的结构效度。生存意愿与生活满意度、幸福感、自评健康状况、士气、自评衰老呈显著正相关，并且如预期的那样，与抑郁和孤独呈负相关，从而支持了同时效度。
这些分析结果表明生存意愿量表是一种有效且可靠的工具。考虑到生存意愿概念在晚年的重要性以及生存意愿量表的心理测量特性，我们建议将其用于与老年人主观幸福感和临终关怀相关的研究和实践中。
