Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
BMC Geriatr. 2017 Oct 26;17(1):251. doi: 10.1186/s12877-017-0641-y.
Most research on multidimensional frailty focuses on deficits and risks of adverse outcomes. However, although some frail older people report a low quality of life (QoL), others still report a relatively high QoL. More knowledge about these discrepancies might give new insight into developing frailty prevention strategies. Therefore, this mixed-method study aimed (a) to identify characteristics related to QoL among frail older people; and (b) to explain discrepancies between higher and lower levels of QoL, with a specific interest in identifying strengths frail older people with a higher QoL still have.
Semi-structured interviews were held with community-dwelling, frail older people with higher (n = 16) and lower levels of QoL (n = 18). Frailty was assessed with the Comprehensive Frailty Assessment Instrument, which measures environmental, physical, psychological, and social frailty. Other quantitative measures included socio-demographic characteristics, overall QoL, meaning in life, and mastery. The qualitative part focused on the meaning and maintenance of QoL (among other factors), despite being frail. Possible explanations for discrepancies in QoL were explored.
Frail older people with a higher QoL were older, had lower levels of psychological frailty, and reported higher meaning in life compared to those with a lower QoL. Outcomes of qualitative analysis showed that participants in the high QoL subgroup adapted more effectively to difficulties, had more things in prospect, performed more activities, and were more satisfied with their social network compared to the low QoL subgroup.
This exploratory study suggests possibilities to promote and improve QoL by strengthening specific resources among frail older people.
大多数多维脆弱性的研究都集中在不良后果的缺陷和风险上。然而，尽管一些虚弱的老年人报告生活质量（QoL）较低，但其他人仍报告相对较高的 QoL。更多关于这些差异的知识可能会为制定虚弱预防策略提供新的见解。因此，这项混合方法研究旨在：（a）确定与虚弱老年人的 QoL 相关的特征；（b）解释 QoL 水平较高和较低之间的差异，特别关注确定具有较高 QoL 的虚弱老年人仍具有的优势。
对社区居住的虚弱老年人进行半结构化访谈，这些老年人的 QoL 水平较高（n=16）和较低（n=18）。用全面虚弱评估工具评估虚弱程度，该工具衡量环境、身体、心理和社会方面的虚弱。其他定量测量包括社会人口统计学特征、总体 QoL、生活意义和掌握。定性部分侧重于 QoL 的意义和维持（除其他因素外），尽管存在虚弱。探索了 QoL 差异的可能解释。
QoL 较高的虚弱老年人年龄较大，心理虚弱程度较低，生活意义较高，与 QoL 较低的老年人相比。定性分析的结果表明，高 QoL 亚组的参与者比低 QoL 亚组更有效地适应困难，有更多的展望，进行更多的活动，对他们的社交网络更满意。
这项探索性研究表明，通过加强虚弱老年人的特定资源，可以促进和提高他们的 QoL。
