A meta-analysis of quality of life in older adults

Date

1994-12

Authors

Hapshe, Elaine M.

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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 Of the 249 studies reviewed, 83 subject-studies comprised the final sample which consisted of published studies and unpublished dissertations/theses conducted between the years 1970-1993.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.

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Keywords

Nursing, Gerontology, Sociology, Quality of life, Older people, Health and environmental sciences, Social sciences, Elderly, Health, Social well-being

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