College of Nursing, University of Santo Tomas, España Boulevard, Manila, 1015, Philippines.
Arch Gerontol Geriatr. 2018 Sep-Oct;78:261-268. doi: 10.1016/j.archger.2018.07.013. Epub 2018 Jul 17.
Although healthy ageing aims for better quality of life, the inability of older adults to adequately care for themselves and their health impair the realization of such objective. Moreover, in a collectivist community like the Philippines, the family, community, and Transcendent are inseparable in promoting quality of life. This study developed and tested a model of quality of life (QoL) among chronically-ill, community-dwelling older adults.
From August to November 2017, a cross-sectional study of 304 chronically-ill, community-dwelling older adults from selected rural communities in the Philippines was conducted. Respondents completed a five-part survey packet composed of the socio-demographic profile, modified Older People's Quality of Life, Spirituality Assessment Scale, Hypertension Self-Care Profile, and Diabetes Self-Management Questionnaire.
Socio-demographics, community satisfaction, spirituality, and disease self-management accounted 29.00% of QoL, generating a good model (χ/df = 1.44, RMSEA = 0.038, and PNFI = 0.64). Spirituality (β = 0.34, p < 0.01) was the strongest predictor of QoL, while community satisfaction had both direct (β = 0.26, p < 0.01) and indirect (β = 0.08, p < 0.01) effects. Disease self-management directly (β = 0.15, p = 0.016) influenced QoL. In contrast, longer chronicity and larger family size impair QoL.
Quality of life among chronically-ill, community-dwelling older adults is a multi-faceted health construct influenced by socio-demographics, disease self-management, community satisfaction, and spirituality. The presented model highlights the positive effect of disease self-management, community satisfaction, and spirituality which can be utilized in developing appropriate community-based geriatric strategies, policies, and programs. Further, forming collaborative groups with socially-active community elderly and community-based self-care programs can be ventured to address the needs of older adults.
尽管健康老龄化旨在提高生活质量，但老年人无法充分照顾自己和他们的健康会影响到这一目标的实现。此外，在菲律宾这样一个集体主义社区，家庭、社区和超越自我在促进生活质量方面是不可分割的。本研究开发并测试了一种慢性病社区老年人生活质量（QoL）模型。
2017 年 8 月至 11 月，对菲律宾选定农村社区的 304 名慢性病社区老年人进行了横断面研究。受访者完成了由社会人口统计学概况、改良老年人生活质量量表、精神评估量表、高血压自我护理量表和糖尿病自我管理问卷组成的五部分调查包。
社会人口统计学、社区满意度、精神信仰和疾病自我管理占生活质量的 29.00%，产生了一个良好的模型（χ/df=1.44，RMSEA=0.038，PNFI=0.64）。精神信仰（β=0.34，p<0.01）是生活质量的最强预测因素，而社区满意度既有直接影响（β=0.26，p<0.01），也有间接影响（β=0.08，p<0.01）。疾病自我管理直接（β=0.15，p=0.016）影响生活质量。相比之下，慢性病程较长和家庭规模较大则会损害生活质量。
慢性病社区老年人的生活质量是一个多方面的健康结构，受社会人口统计学、疾病自我管理、社区满意度和精神信仰的影响。所提出的模型突出了疾病自我管理、社区满意度和精神信仰的积极影响，可用于制定适当的基于社区的老年策略、政策和方案。此外，可以尝试与社会活跃的社区老年人和基于社区的自我护理方案形成合作小组，以满足老年人的需求。
