Determinants of Functional Quality of Life in Community-Living Older Adults

Donna S. Sachse, PhD, RN, CS¹, Judy C. Martin, PhD, APN, BC², Mona N. Wicks, PhD, RN³, James M. Pruett, PhD⁴, Susan Jacob, PhD, RN⁴, Margaret Thorman Hartig, PhD, APN, BC⁴, and Sarah L. Mynatt, RN, EdD⁴. (1) School of Nursing, Union University, Germantown, TN, USA, (2) Nursing, Memphis and Shelby County Health Department, Memphis, TN, USA, (3) College of Nursing, The University of Tennessee, Memphis, Health Science Center, Memphis, TN, USA, (4) College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA

Objective: The study purpose was to examine contributions of psychological, social, and physical function indices and functional quality of life (FQOL) in community living older adults.

Design: The descriptive-correlational study design was cross-sectional in nature.

Sample and Setting: The convenience sample consisted of 100 older adults residing in mid-southern, senior rental-assisted housing.

Methods: Participants responded verbally to instrument items and walked an eight-foot distance while being timed. Eight instruments were used: sociodemographic questionnaire (age, gender, race, education years); Short Portable Mental Status Questionnaire; Center for Epidemiologic Studies Depression Scale; State-Trait Anxiety Inventory; Spiritual Well-Being Scale; Satisfaction with Social Support Cantril Ladder; Timed 8-Foot Walk (walking speed as physical performance surrogate); Medical Outcomes Studies Short-Form –12v2 to assess FQOL. Multiple regression analyses were computed to determine relationships among study variables.

Findings: Generally, participants were cognitively intact, experiencing high levels of spiritual well-being, satisfied with their social support, and mobile. However, psychosocial and physical FQOL scores were low. Regression analyses revealed unexpected variable influences on FQOL. Anxiety was most influencing on psychosocial FQOL. Spiritual well-being was influencing for male and female physical FQOL. Although 60 percent of the variance for physical FQOL of males was explained, only 17 percent of physical FQOL was explained for females. With the exception of education, there were no racial differences in predictors of FQOL. Conclusions: Quality of life is foremost a subjective phenomenon. The older adult’s personal perspective is significant for measures of FQOL. Psychosocial indices strongly influence FQOL, particularly anxiety, depression, and spiritual well-being.

Implications: This study lends strong support for screening for anxiety in addition to depression in the older adult and for promoting spiritual well-being to enhance FQOL. Instruments that solicit the client’s opinion concerning daily functioning would provide a thorough and truthful picture of FQOL and better inform and direct interventions.