A meta-analysis of quality of life in older adults

Abstract

The purpose of the study was to identify physical, psychological, social, spiritual, and economic variables predictive of Quality of Life (QOL) among community-residing healthy and chronically ill adults aged 55$\sp{+}$ years. In this study, QOL was specifically defined as the older adult's subjective evaluation and perceived importance of life domains over a particular period of time. QOL is an elusive, multidimensional, and dynamic concept that reflects ongoing responses to events affecting a person's life.

The conceptual framework developed for the study was adapted from Zhan's (1992) Conceptual Model of Quality of Life. The framework included: (a) antecedents--personal background, health-related, environmental, and cultural factors; (b) intervening variables--personal meaning in life, adaptation, and coping behaviors; and (c) consequences--QOL and domains such as physical/psychological/social well-being, spiritual integrity, and economic security.

The research design of the study was based upon the methodological framework of meta-analysis. Nonprobability sampling was used to select subject-studies from the disciplines of: nursing, psychology, sociology, medicine, allied/public health, and education. Of the 249 studies reviewed, 83 subject-studies comprised the final sample which consisted of published studies and unpublished dissertations/theses conducted between the years 1970-1993. Subjects in the meta-analytic studies were predominantly caucasian and Afro-American females.

Prior to data collection, the subject-studies were rated for methodological quality. The methodological and substantive data of the studies were collected using a two-part Coding Instrument developed by this investigator. Data obtained were analyzed using Pearson's product moment and eta coefficients, t-test, oneway analysis of variance, test of homogeneity, Fail Safe N, and multiple regression.

Of the five QOL domains, social well-being demonstrated the largest effect size and strongest domain predictive of QOL. Although economic security was not a predictor of QOL, it did reveal a small to medium effect size. In terms of the indicator variables, religiosity was strongly predictive of QOL followed by: subjective health, mental health, social activity/support, socioeconomic status, and adequacy of social resources. Findings of the meta-analytic study have implications for nursing theory, research, and practice.