Developing and testing a model of quality of life among chronically-ill, community-dwelling older adults: A structural equation model.

Purpose: Although healthy ageing aims for better quality of life, the inability of older adults to adequately care for themselves and their health impair the realization of such objective. Moreover, in a collectivist community like the Philippines, the family, community, and Transcendent are inseparable in promoting quality of life. This study developed and tested a model of quality of life (QoL) among chronically-ill, community-dwelling older adults.

Materials And Methods: From August to November 2017, a cross-sectional study of 304 chronically-ill, community-dwelling older adults from selected rural communities in the Philippines was conducted. Respondents completed a five-part survey packet composed of the socio-demographic profile, modified Older People's Quality of Life, Spirituality Assessment Scale, Hypertension Self-Care Profile, and Diabetes Self-Management Questionnaire.

Results: Socio-demographics, community satisfaction, spirituality, and disease self-management accounted 29.00% of QoL, generating a good model (χ/df = 1.44, RMSEA = 0.038, and PNFI = 0.64). Spirituality (β = 0.34, p < 0.01) was the strongest predictor of QoL, while community satisfaction had both direct (β = 0.26, p < 0.01) and indirect (β = 0.08, p < 0.01) effects. Disease self-management directly (β = 0.15, p = 0.016) influenced QoL. In contrast, longer chronicity and larger family size impair QoL.

Conclusion: Quality of life among chronically-ill, community-dwelling older adults is a multi-faceted health construct influenced by socio-demographics, disease self-management, community satisfaction, and spirituality. The presented model highlights the positive effect of disease self-management, community satisfaction, and spirituality which can be utilized in developing appropriate community-based geriatric strategies, policies, and programs. Further, forming collaborative groups with socially-active community elderly and community-based self-care programs can be ventured to address the needs of older adults.