Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands.
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, P.O. Box 1738, 3000 DR, Rotterdam, the Netherlands; Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, the Netherlands.
Soc Sci Med. 2019 Nov;240:112535. doi: 10.1016/j.socscimed.2019.112535. Epub 2019 Sep 10.
Population ageing and restricted budgets result in the need for an efficient allocation of scarce resources in care services for older people. As these services tend to address more than only health, diverse wellbeing measures have been developed to assess their benefits in economic evaluations. These measures are grounded in research on wellbeing of older people and its determinants. Little is known about possible heterogeneity in this context and the extent to which wellbeing measures cover the aspects of wellbeing that are most important to older people with different views on wellbeing. We conducted a Q-methodology study between December 2016 and October 2017 to investigate the variety in views among people aged 65 and older in the Netherlands on what is important to their wellbeing. A purposive sample of 53 respondents ranked 34 opinion statements according to importance to their wellbeing and explained their ranking during a follow-up interview. Data were analysed using by-person factor analysis to identify common patterns in the rankings of the statements. Five distinct views were extracted in which different aspects were considered important: (I) health, financial security and a life partner; (II) family, support and physical functioning (III); autonomy, mental health and helping others; (IV) social contacts, support, mental health and religion; and (V) a life partner, social contacts, living environment and adaptation. This heterogeneity in views of older people on what constitutes wellbeing supports the use of person-centered approaches in care services for older people. Arguably, (evaluations of) policies and services for older people should take this plurality into consideration.
人口老龄化和预算限制导致需要在老年人护理服务中高效分配稀缺资源。由于这些服务往往不仅仅涉及健康，因此已经开发了多种福祉衡量标准来评估其在经济评估中的效益。这些衡量标准基于对老年人福祉及其决定因素的研究。对于在不同福祉观下，对于具有不同福祉观的老年人而言，哪些福祉方面最重要，这种多样性以及福祉衡量标准涵盖的程度，知之甚少。我们在 2016 年 12 月至 2017 年 10 月之间进行了一项 Q 方法论研究，以调查荷兰 65 岁及以上人群对福祉的重要性的看法差异。我们通过目的性抽样选择了 53 名受访者，根据对他们福祉的重要性对 34 条意见陈述进行了排名，并在后续访谈中解释了他们的排名。通过个人因素分析对数据进行了分析，以确定陈述排名中的共同模式。从中提取了五个不同的观点，其中考虑了不同的方面：（I）健康、财务安全和生活伴侣；（II）家庭、支持和身体功能；（III）自主性、心理健康和帮助他人；（IV）社会联系、支持、心理健康和宗教；以及（V）生活伴侣、社会联系、生活环境和适应能力。老年人对构成福祉的看法存在这种异质性，支持在老年人护理服务中采用以人为本的方法。可以说，（对）老年人的政策和服务应该考虑到这种多样性。
