A Structural Equation Model of the Factors Affecting Morale of a Select Group of Filipino Elderly in a Community Setting

Abstract

While morale among the elderly has been widely and extensively studied, results are varied and at times conflicting. Hence, the purpose of this study is to explore the factors affecting elderly morale of a select group of Filipinos in a community setting. A 64-item questionnaire was utilized to survey 323 Filipinos aged 60 and above residing in the National Capital Region of the Philippines in May 2013. Respondents completed a robotfoto, a checklist of chronic illnesses, and measures of the social support, functional ability, geriatric depression, and morale. Structural equation modeling was used to test the hypothesized model. Two competing models emerged in the study. Model 1 followed causal relationships indicated in the hypothesized model while model 2 considered modification indices that surfaced more acceptable fit indices (X 2 =df ¼ 1.414, GFI [goodness of fit index] ¼ 0.988, CFI [comparative fit index] ¼ 0.987, RMSEA [root mean square error of approximation] ¼ 0.036). Chronic illness, social support, and depression were found to be major predictors of morale. Number of chronic illnesses and depression were also found to have a negative relationship with functional ability, and chronic illness and social support were negatively correlated. Findings can assist health professionals such as nurses to identify the factors that shape elderly morale vis-a-vis the use of effective strategies that promote the well-being of elderly people. The emerging model can serve as reference to assess the effectiveness of quality of care rendered as manifested by morale.Several studies have indicated that, by and large, morale is often used synonymously with life satisfaction, subjective or psychological well-being, and quality of life (

Morale in Old Age and Its Association with Sociodemographic, Social, and Health-Related Factors in Different Age Groups

“…In contrast with some previous studies of morale and age [13,18], the level of morale was lower in the older age groups. e results from the present study are, however, in line with the study of de Guzman et al [12] and with several studies of measures of SWB, where lower levels of well-being have been noted among the oldest-old (e.g. [20]).…”

Risk factors for a decrease in high morale in very old people over a 5-year period: data from two Nordic countries

“…Further, it is evident that the relationship between healthrelated variables and morale in old age is complex, especially considering that different studies have come to somewhat conflicting results. Mancini and Quinn's study (1981) found no associations between morale and for example the use of medical services or the number of illnesses, while the history of hospitalization in the study of Iwasa et al (2006) and the number of chronic illnesses in the study of de Guzman et al (2015) were found to be associated with lower morale. The differing results might partly be explained by the use of different measurements of illness and differences in methodology.…”

“…In Litwin's (2001) study, individuals with more restricted social networks had lower morale than those with broad social networks that included family, friends and neighbors. Lower social support (de Guzman et al 2015;Loke et al 2011) and living alone (Iwasa et al 2006) have further been associated with lower morale. In samples of very old people, lower satisfaction with support from family (Deng et al 2010) and perceived loneliness (von Heideken Wågert et al 2005) have been associated with lower morale.…”

“…In the general elderly population, health-related factors such as fatigue, poor visual acuity, more non-prescriptive medicines for regular use (Mancini and Quinn 1981), chronic conditions (de Guzman et al 2015;Iwasa et al 2006), disability due to chronic illness (Loke et al 2011), low levels of activity, problems with mobility, moderate to severe pain, and limitations in self-care (Kisely and Shannon 1999) have been associated with lower morale. Additionally, stroke (Niklasson et al 2014) urinary tract infection (Eriksson et al 2010), and cognitive function (Deng et al 2010) have been associated with morale in very old age.…”

“…Some cross-sectional studies of morale have shown that the level of morale is higher in older ages (Iwasa et al 2006;Woo et al 2005), while others have shown that the level of morale is lower in advanced age (de Guzman et al 2015). However, no study on morale in old age has, to our knowledge, focused on whether the same social and healthrelated factors affect morale in different age groups, i.e., if results regarding risk factors for lower morale in younger old also apply to very old age.…”