School of Social Work, Massey University, Palmerston North, New Zealand.
School of Health Sciences, Massey University, Palmerston North, New Zealand.
Disabil Rehabil. 2021 Jan;43(2):181-191. doi: 10.1080/09638288.2019.1620875. Epub 2019 Jul 23.
Purpose in life and capabilities are two significant individual elements that enhance quality of life among older people. Capabilities refers to the extent to which older people are free to make choices that are important to them. At present, it is not known how purpose in life interacts with capabilities to influence quality of life for those living with a disability. This study examined the extent to which purpose in life and capabilities interacts with health status to affect quality of life, particularly for older people with a disability. Self-report data from participants in a longitudinal cohort study of older New Zealanders were analyzed. Responses from 452 older people with a disability were compared with 3299 age- and gender-matched older people without a disability on indicators related to health and aging. The associations were tested using hierarchical regression. Mediational impact of purpose in life and capabilities were tested via path analysis. Mental health, physical health, purpose in life, and capabilities accounted for a significant amount of variance in quality of life for older people with a disability. Purpose in life and capabilities were significant unique mediators for older people with a disability. Purpose in life may help older people with a disability to deal with early onset stressors or changes in mental and physical health to maintain overall quality of life. The role of capabilities suggests that the social environment and access to resources and choices are important in ensuring that older people aging with or into a disability achieve quality of life in a socially just environment.Implications for rehabilitationsPurpose in life and capability are unique mediators of the relationship between health status and quality of life.Purpose in life may act as an effective buffering mechanism to deal with disability in later life while capability can empower older people with a disability to achieve quality of life in a just environment.The notion of successful aging with disability should be re-defined as using psychological, social support, and healthcare resources to live a life consistent with personal values in the context of disabilityRather than emphasizing structural factors and physical functioning in activity participation, older people with disability should be supported to decide and pursue their own preferences.Rehabilitation professionals can work flexibly with older people with disability to maximize their resilience, dignity, autonomy and choice, and positive connection to others.
生活目的和能力是两个重要的个体因素，它们可以提高老年人的生活质量。能力是指老年人在多大程度上可以自由地做出对他们重要的选择。目前，尚不清楚生活目的与能力如何相互作用，以影响残疾老年人的生活质量。本研究探讨了生活目的和能力与健康状况相互作用，从而影响生活质量的程度，特别是对残疾老年人而言。分析了新西兰一项针对老年人的纵向队列研究中参与者的自我报告数据。将 452 名残疾老年人与 3299 名年龄和性别相匹配的无残疾老年人在与健康和衰老相关的指标上进行了比较。使用层次回归法检验了相关性。通过路径分析测试了生活目的和能力的中介作用。心理健康、身体健康、生活目的和能力解释了残疾老年人生活质量的很大一部分差异。生活目的和能力是残疾老年人的重要独特中介因素。生活目的可能有助于残疾老年人应对早期压力源或心理健康和身体健康的变化，以维持整体生活质量。能力的作用表明，社会环境以及获得资源和选择的机会对于确保残疾老年人在一个公平的社会中实现生活质量至关重要。
康复意义
生活目的和能力是健康状况与生活质量之间关系的独特中介因素。
生活目的可能是一种有效的缓冲机制，可以帮助老年人在晚年应对残疾，而能力可以赋予残疾老年人在公平的环境中实现生活质量的权力。
残疾老年人成功老龄化的概念应该重新定义为在残疾背景下，利用心理、社会支持和医疗保健资源，按照个人价值观生活，而不是强调结构因素和身体功能在活动参与中的作用。残疾老年人应该得到支持，以决定并追求自己的喜好。
康复专业人员可以灵活地与残疾老年人合作，最大限度地提高他们的适应能力、尊严、自主权和选择能力，以及与他人的积极联系。
