Bordne Saskia, Rietz Christian, Schulz Ralf-Joachim, Zank Susanne
Faculty of Human Sciences, Graduate School GROW, Gerontological Research on Well-Being, University of Cologne, Aachener Str. 201, 50931, Cologne, Germany.
Department of Educational Science, Mixed Methods-Research, PH Heidelberg | University of Education, Keplerstraße 87, 69221, Heidelberg, Germany.
Eur Geriatr Med. 2019 Dec;10(6):965-975. doi: 10.1007/s41999-019-00240-x. Epub 2019 Sep 16.
The study focused on indicators of subjective well-being (SWB) and how they developed during and after geriatric rehabilitation. Furthermore, a biopsychosocial prediction model for longer-term SWB was tested.
Patients of an inpatient geriatric rehabilitation unit were assessed at admission, discharge and a three-month follow-up. Indicators of SWB comprised affect, life satisfaction, valuation of life and autonomy. Further, biomedical and psychosocial variables assessed upon admission were used to predict SWB at follow-up. Statistical analysis included repeated-measures (M)ANOVA depicting SWB development over time with Cohen's d for effect size, along with canonical correlation analyses used to test the biopsychosocial prediction model.
78 out of 122 patients were assessed three times. Across all measurement points, different change patterns among SWB indicators were detected: Positive affect was significantly higher at follow-up than at admission (mean difference (MD) = .28, p < .01, Cohen's d = .37). Negative affect declined during rehabilitation (MD = - .29, p < .01, Cohen's d = .40) but increased again until follow-up (MD = .31, p < .01, Cohen's d = .42). Life satisfaction and valuation of life showed no change over time, while experience of autonomy gradually worsened from admission until follow-up (MD = - .29, p < .05, Cohen's d = .32). The biopsychosocial model revealed that personality traits and control beliefs best predicted SWB at follow-up.
Although geriatric rehabilitation has a positive effect on affect, it does not consistently improve other SWB indicators. Moreover, paying attention to psychological parameters such as personality in the daily geriatric routine could help to identify patients for whom longer-term SWB is particularly at risk.
本研究聚焦于主观幸福感（SWB）指标及其在老年康复期间及之后的发展情况。此外，还测试了一个用于长期主观幸福感的生物心理社会预测模型。
对一家老年康复住院单元的患者在入院、出院及三个月随访时进行评估。主观幸福感指标包括情感、生活满意度、生活价值评估和自主性。此外，入院时评估的生物医学和心理社会变量用于预测随访时的主观幸福感。统计分析包括重复测量（M）方差分析，用科恩d值描述主观幸福感随时间的发展效应大小，以及用于测试生物心理社会预测模型的典型相关分析。
122名患者中有78名接受了三次评估。在所有测量点，主观幸福感指标呈现出不同的变化模式：随访时的积极情感显著高于入院时（平均差异（MD）=0.28，p<0.01，科恩d值=0.37）。消极情感在康复期间下降（MD=-0.29，p<0.01，科恩d值=0.40），但到随访时又再次上升（MD=0.31，p<0.01，科恩d值=0.42）。生活满意度和生活价值评估随时间无变化，而自主性体验从入院到随访逐渐变差（MD=-0.29，p<0.05，科恩d值=0.32）。生物心理社会模型显示，人格特质和控制信念最能预测随访时的主观幸福感。
尽管老年康复对情感有积极影响，但并不能持续改善其他主观幸福感指标。此外，在日常老年护理中关注人格等心理参数，有助于识别那些长期主观幸福感特别有风险的患者。
