What does quality of life mean to older adults? A thematic synthesis

Abstract

Background Consideration of older adults’ quality of life (QoL) is becoming increasingly important in the evaluation, quality improvement and allocation of health and social care services. While numerous definitions and theories of QoL have been proposed, an overall synthesis of the perspective of older adults themselves is lacking. Methods Qualitative studies were identified in PubMed, Ebsco/Psycinfo and Ebsco/CINAHL, through a search on 28 November 2018. Articles needed to meet all of the following criteria: (i) focus on perceptions of QoL, (ii) older adults living at home as main participants, (iii) use of qualitative methodology, (iv) conducted in a Western country and (v) published in English (vi) not focused on specific patient groups. A thematic synthesis was conducted of the selected studies, using the complete ‘findings/results’ sections from the papers. Results We included 48 qualitative studies representing the views of more than 3,400 older adults living at home in 11 Western countries. The QoL aspects identified in the synthesis were categorized into nine QoL domains: autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighbourhood, and financial security. The results showed that although different domains can be distinguished, these are also strongly connected. Conclusion QoL can be expressed in a number of domains and related subthemes that are important for older adults living at home. The findings further support that the concept of QoL should be seen as a dynamic web of intertwined domains.

Association of Family Type with Happiness Attributes Among Older Adults

“…These results were consistent with Kim's [21] finding that education and household income affect the quality of life of older adults. According to Van Leeuwen et al [14], financial resources affect older adults' quality of life, feelings of independence, and access to a comfortable life. Additionally, the present findings were consistent with those of previous studies [7,14,21,22,23] that reported that depression and health status were closely related to happiness.…”

“…According to Van Leeuwen et al [14], financial resources affect older adults' quality of life, feelings of independence, and access to a comfortable life. Additionally, the present findings were consistent with those of previous studies [7,14,21,22,23] that reported that depression and health status were closely related to happiness. Further, Kim, Song, Kim, and Park [22] reported that depressive symptoms were powerful predictors of happiness in older women living alone.…”

“…This finding suggests that, in older adults living with their family, contact with neighbors or friends did not seem to be significantly associated with happiness. The older adults living with their family were more dependent and focused on the family, such as children [14].…”

“…Studies have examined concepts similar to happiness, including well-being [7], quality of life [9,12,13,14], life satisfaction [6,15,16], subjective well-being [17], good life, and better life [5,18].…”

“…Previous studies [14,19,20] have suggested various factors influencing older adults' happiness. Van Leeuwen et al [14] identified the following nine quality of life domains for older adults living at home: autonomy, role and activity, health perception, relationships, attitude and adaptation, emotional comfort, spirituality, home and neighborhood, and financial security.…”