Vogel Nina, Ram Nilam, Goebel Jan, Wagner Gert G, Gerstorf Denis
1German Institute for Economic Research (DIW Berlin), Mohrenstraße 58, 10117 Berlin, Germany.
2Department of Psychology, Humboldt University Berlin, Unter den Linden 6, 10099 Berlin, Germany.
Eur J Ageing. 2017 Jul 19;15(2):111-122. doi: 10.1007/s10433-017-0425-4. eCollection 2018 Jun.
Both lifespan psychology and life course sociology highlight that contextual factors influence individual functioning and development. In the current study, we operationalize context as county-level care services in inpatient and outpatient facilities (e.g., number of care facilities, privacy in facilities) and investigate how the care context shapes well-being in the last years of life. To do so, we combine 29 waves of individual-level longitudinal data on life satisfaction from now deceased participants in the nationwide German Socio-Economic Panel Study ( = 4557; age at death: = 73.35, SD = 14.20; 47% women) with county-level data from the Federal Statistical Office. Results from three-level growth models revealed that having more inpatient care facilities, more employees per resident, and more staff in administration are each uniquely associated with higher late-life well-being, independent of key individual (age at death, gender, education, disability) and county (affluence, demographic composition) characteristics. Number of employees in physical care, residential comfort, and flexibility and care indicators in outpatient institutions were not found to be associated with levels or change in well-being. We take our results to provide empirical evidence that some contextual factors shape well-being in the last years of life and discuss possible routes how local care services might alleviate terminal decline.
寿命心理学和生命历程社会学都强调，情境因素会影响个体的机能和发展。在本研究中，我们将情境操作化为县级住院和门诊设施中的护理服务（例如，护理设施的数量、设施中的隐私情况），并研究护理情境如何塑造生命最后几年的幸福感。为此，我们将来自德国全国社会经济小组研究中现已去世参与者的29轮关于生活满意度的个体层面纵向数据（n = 4557；死亡年龄：M = 73.35，标准差 = 14.20；47%为女性）与联邦统计局的县级数据相结合。三级增长模型的结果显示，拥有更多的住院护理设施、更高的人均员工数量以及更多的行政人员，均与更高的晚年幸福感存在独特关联，且不受关键个体特征（死亡年龄、性别、教育程度、残疾情况）和县级特征（富裕程度、人口构成）的影响。未发现身体护理员工数量、居住舒适度以及门诊机构的灵活性和护理指标与幸福感水平或变化存在关联。我们认为我们的研究结果为一些情境因素塑造生命最后几年的幸福感提供了实证依据，并讨论了当地护理服务可能缓解末期衰退的可能途径。
