Advertisement

Tijdschrift voor Gerontologie en Geriatrie

, Volume 49, Issue 5, pp 174–186 | Cite as

Het verklaren van verschillen in ervaren kwaliteit van leven van kwetsbare ouderen: een ‘mixed-method’ onderzoek

  • Anne van der Vorst
  • G. A. Rixt Zijlstra
  • Nico De Witte
  • Ruth G. M. Vogel
  • Jos M. G. A. Schols
  • Gertrudis I. J. M. Kempen
  • D-SCOPE Consortium
Oorspronkelijk artikel
  • 234 Downloads

Samenvatting

Onderzoek over (multidimensionale) kwetsbaarheid richt zich veelal op tekortkomingen en het risico op negatieve gevolgen. Kwetsbare ouderen kunnen echter ook positieve uitkomsten ervaren, zoals een goede kwaliteit van leven (KvL). Om nieuwe, meer positief georiënteerde preventiestrategieën te kunnen ontwikkelen richt dit exploratief onderzoek zich op (a) het identificeren van factoren gerelateerd aan de KvL van kwetsbare ouderen; en (b) het verklaren van verschillen tussen kwetsbare ouderen met respectievelijk een ‘hoge’ en ‘lage’ KvL. Bij dit laatste ligt de focus op het identificeren van sterktes die kwetsbare ouderen met een ‘hoge’ KvL hebben. Kwantitatieve en kwalitatieve data zijn verzameld door middel van semigestructureerde interviews met Vlaamse thuiswonende, kwetsbare ouderen met een hoge (N = 16) en lage KvL (N = 18). De kwantitatieve analyses lieten zien dat de hoge KvL groep ouder was, in mindere mate psychisch kwetsbaar was en een hogere mate van zingeving rapporteerde dan de lage KvL groep. De kwalitatieve analyses wezen uit dat de ouderen in de hoge KvL groep beter omgingen met moeilijkheden, meer gebeurtenissen in het vooruitzicht hadden, meer activiteiten ondernamen en meer tevreden waren met hun sociale netwerk. Concluderend biedt dit exploratief onderzoek handvatten om de KvL van ouderen, ondanks hun kwetsbaarheid, te verhogen.

Een Engelstalige versie van dit artikel is verschenen in BMC Geriatrics: van der Vorst A, Zijlstra GAR, De Witte N, Vogel RGM, Schols JMGA, Kempen GIJM, D‑SCOPE Consortium. Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study. BMC Geriatr. 2017;17(1): 251.  https://doi.org/10.1186/s12877-017-0641-y.

Trefwoorden

multidimensionale kwetsbaarheid welzijn kwalitatief onderzoek positieve gezondheid 

Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study

Abstract

Most research on (multidimensional) frailty focuses on deficits and risks of adverse outcomes. However, frail older people can still report positive outcomes, such as a relatively high QoL. In order to develop more positively oriented prevention strategies, this exploratory study aimed (a) to identify characteristics related to QoL among frail older people; and (b) to explain discrepancies between higher and lower levels of QoL, with a specific focus on strengths frail older people with a higher QoL still may have. Quantitative and qualitative data was gathered by means of semi-structured interviews with Flemish community-dwelling, frail older people with higher (n = 16) and lower QoL levels (n = 18). Quantitative analyses showed that frail older people with a higher QoL were older, had lower levels of psychological frailty, and reported higher meaning in life compared to those with a lower QoL. Outcomes of qualitative analysis showed that participants in the high QoL subgroup adapted more effectively to difficulties, had more things in prospect, performed more activities, and were more satisfied with their social network compared to the low QoL subgroup. To conclude, this exploratory study suggests possibilities to promote and improve QoL by strengthening specific resources among frail older people.

Please note that an English version of this article has been published in BMC Geriatrics: van der Vorst A, Zijlstra GAR, De Witte N, Vogel RGM, Schols JMGA, Kempen GIJM, D‑SCOPE Consortium. Explaining discrepancies in self-reported quality of life in frail older people: a mixed-methods study. BMC Geriatr. 2017;17(1): 251.  https://doi.org/10.1186/s12877-017-0641-y.

Keywords

Multidimensional frailty Wellbeing Qualitative study Strengths-based approach 

Notes

Dankbetuiging

De auteurs willen alle ouderen die hebben deelgenomen aan dit onderzoek bedanken.

Financiering

De auteurs zijn erkentelijk voor de onderzoeksfinanciering van het Agentschap voor Innovatie door Wetenschap en Technologie (IWT-140027-SBO).

Supplementary material

12439_2018_261_MOESM1_ESM.docx (19 kb)
Bijlage I. Overzicht kwantitatieve en kwalitatieve dataverzameling.

Literatuur

  1. 1.
    Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in Older Adults: Evidence for a Phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146–57.CrossRefGoogle Scholar
  2. 2.
    De Witte N, Gobbens R, De Donder L, Dury S, Buffel T, Schols JMGA, Verté D. The comprehensive frailty assessment instrument: Development, validity and reliability. Geriatr Nurs. 2013;34(4):274–81.CrossRefPubMedGoogle Scholar
  3. 3.
    De Roeck EE, Dury S, De Witte N, De Donder L, Bjerke M, De Deyn PP, et al. CFAI-Plus: Adding cognitive frailty as a new domain to the Comprehensive Frailty Assessment Instrument. Int J Geriatr Psychiatry. 2018;33(7):941–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of Frailty in Community-Dwelling Older Persons: A Systematic Review. J Am Geriatr Soc. 2012;60(8):1487–92.CrossRefPubMedGoogle Scholar
  5. 5.
    Dury S, De Roeck E, Duppen D, Fret B, Hoeyberghs L, Lambotte D, et al. Identifying frailty risk profiles of home-dwelling older people: Focus on sociodemographic and socioeconomic characteristics. Aging Ment Health. 2016;2016  https://doi.org/10.1080/13607863.2016.1193120.CrossRefPubMedGoogle Scholar
  6. 6.
    Gobbens RJJ, Assen MALM van, Luijkx KG, Schols JMGA. The Predictive Validity of the Tilburg Frailty Indicator: Disability, Health Care Utilization, and Quality of Life in a Population at Risk. Gerontologist. 2012;52(5):619–31.CrossRefPubMedGoogle Scholar
  7. 7.
    Song X, Mitnitski A, Rockwood K. Prevalence and 10-Year Outcomes of Frailty in Older Adults in Relation to Deficit Accumulation. J Am Geriatr Soc. 2010;58(4):681–7.CrossRefPubMedGoogle Scholar
  8. 8.
    Wiles JL, Leibing A, Guberman N, Reeve J, Allen RES. The Meaning of “Aging in Place” to Older People. Gerontologist. 2012;52(3):357–66.  https://doi.org/10.1093/geront/gnr098.CrossRefPubMedGoogle Scholar
  9. 9.
    Scharlach A. Creating Aging-Friendly Communities in the United States. Ageing Int. 2011;37(1):25–38.CrossRefGoogle Scholar
  10. 10.
    European Commission. Aging Report 2014. 2015. http://ec.europa.eu/economy_finance/publications/european_economy/2014/pdf/ee8_en.pdf. Geraadpleegd op: 15 mrt 2017.Google Scholar
  11. 11.
    Rockwood K, Mitnitski A. Frailty in relation to the accumulation of deficits. J Gerontol A Biol Sci Med Sci. 2007;62a(7):722–7.CrossRefGoogle Scholar
  12. 12.
    Lette M, Baan CA, Berg M van den, Bruin SR de. Initiatives on early detection and intervention to proactively identify health and social problems in older people: Experiences from the Netherlands. Bmc Geriatr. 2015;15:143.  https://doi.org/10.1186/s12877-015-0131-z.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Kempen JAL van, Robben SHM, Zuidema SU, Olde Rikkert MGM, Melis RJF, Schers HJ. Home visits for frail older people: A qualitative study on the needs and preferences of frail older people and their informal caregivers. Br J Gen Pract. 2012;62(601):554–60.CrossRefGoogle Scholar
  14. 14.
    Warmoth K, Lang IA, Phoenix C, Abraham C, Andrew MK, Hubbard RE, Tarrant M. “Thinking you’re old and frail”: A qualitative study of frailty in older adults. Ageing Soc. 2015;36:1483–500.CrossRefGoogle Scholar
  15. 15.
    Graybeal C. Strengths-Based Social Work Assessment: Transforming the Dominant Paradigm. Fam Soc. 2001;82(3):233–42.CrossRefGoogle Scholar
  16. 16.
    Minimol K. Risk Assessment and Strengths Based Case Management in Elderly Care–Scope of Social Work Practice. J Soc Sci. 2016;15(2):121–33.Google Scholar
  17. 17.
    Ament BHL, Vugt ME de, Verhey FRJ, Kempen GIJM. Are physically frail older persons more at risk of adverse outcomes if they also suffer from cognitive, social, and psychological frailty? Eur J Ageing. 2014;11(3):213–9.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Zaslavsky O, Woods NF, LaCroix AZ, Cauley JA, Johnson KC, Cochrane BB, Sagi SZ. Identification of Risk Factors for Mortality and Poor-Quality-of-Life Survival in Frail Older Women Participating in the Women’s Health Initiative Observational Study. J Am Geriatr Soc. 2016;64(4):831–7.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Puts MTE, Shekary N, Widdershoven G, Heldens J, Lips P, Deeg DJH. What does quality of life mean to older frail and non-frail community-dwelling adults in the Netherlands? Qual Life Res. 2007;16(2):263–77.  https://doi.org/10.1007/s11136-006-9121-0.CrossRefPubMedGoogle Scholar
  20. 20.
    Bilotta C, Bowling A, Casè A, Nicolini P, Mauri S, Castelli M, Vergani C. Dimensions and correlates of quality of life according to frailty status: A cross-sectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Outcomes. 2010;8(56):1–10.Google Scholar
  21. 21.
    Smetcoren AS, Dury S, De Donder L, Dierckx E, De Witte N, et al. Detectie en preventie van kwetsbaarheid: Op zoek naar risicoprofielen voor fysieke, psychische, sociale en omgevingskwetsbaarheid. Tijdschr Gerontol Geriatr. 2018;49(1):1–11.CrossRefPubMedGoogle Scholar
  22. 22.
    De Witte N, Gobbens R, De Donder L, Dury S, Buffel T, Verté D, Schols JMGA. Validation of the Comprehensive Frailty Assessment Instrument against the Tilburg Frailty Indicator. Eur Geriatr Med. 2013;4(4):248–54.  https://doi.org/10.1016/j.eurger.2013.03.001.CrossRefGoogle Scholar
  23. 23.
    Nasreddine ZS, Phillips NA, Bédirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53)4:695–9.CrossRefGoogle Scholar
  24. 24.
    Lam B, Middleton LE, Masellis M, Stuss DT, Harry RD, Kiss A, Black SE. Criterion and Convergent Validity of the Montreal Cognitive Assessment with Screening and Standardized Neuropsychological Testing. J Am Geriatr Soc. 2013;61:2181–5.  https://doi.org/10.1111/jgs.12541.CrossRefPubMedGoogle Scholar
  25. 25.
    Polit DF, Beck CT. Nursing Research. Generating and Assessing Evidence for Nursing Practice. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2008.Google Scholar
  26. 26.
    Dierckx de Casterlé B, Gastmans C, Bryon E, Denier Y. QUAGOL: A guide for qualitative data analysis. Int J Nurs Stud. 2012;49(3):360–71.CrossRefPubMedGoogle Scholar
  27. 27.
    Aberg AC, Sidenvall B, Hepworth M, O’Reilly K, Lithell H. On loss of activity and independence, adaptation improves life satisfaction in old age—a qualitative study of patients’ perceptions. Qual Life Res. 2005;14(4):1111–25.CrossRefPubMedGoogle Scholar
  28. 28.
    Albrecht GL, Devlieger PJ. The disability paradox: high quality of life against all odds. Soc Sci Med. 1999;48(8):977–88.CrossRefPubMedGoogle Scholar
  29. 29.
    Bernard M, Braunschweig G, Fegg MJ, Borasio GD. Meaning in life and perceived quality of life in Switzerland: results of a representative survey in the German, French and Italian regions. Health Qual Life Outcomes. 2015;13:160.  https://doi.org/10.1186/s12955-015-0353-y.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Park CL, Malone MR, Suresh DP, Bliss D, Rosen RI. Coping, meaning in life, and quality of life in congestive heart failure patients. Qual Life Res. 2008;17:21.  https://doi.org/10.1007/s11136-007-9279-0.CrossRefPubMedGoogle Scholar
  31. 31.
    Gobbens RJJ, Luijkx KG, Assen MALM van. Explaining quality of life of older people in the Netherlands using a multidimensional assessment of frailty. Qual Life Res. 2013;22:2051–61.  https://doi.org/10.1007/s11136-012-0341-1.CrossRefPubMedGoogle Scholar
  32. 32.
    Coelho T, Paúl C, Fernandes L. Physical, Psychological and Social Frailty in Prediction of Disability and Quality of Life. Eur Psychiatry. 2015;30(1):447.CrossRefGoogle Scholar
  33. 33.
    Hubbard RE, Goodwin VA, Llewellyn DJ, Warmoth K, Lang IA. Frailty, financial resources and subjective well-being in later life. Arch Gerontol Geriatr. 2014;58(3):364–9.CrossRefPubMedGoogle Scholar
  34. 34.
    Lloyd A, Kendall M, Starr JM, Murray SA. Physical, social, psychological and existential trajectories of loss and adaptation towards the end of life for older people living with frailty: A serial interview study. Bmc Geriatr. 2016;16:176.  https://doi.org/10.1186/s12877-016-0350-y.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Moons P, Budts W, De Geest S. Critique on the conceptualisation of quality of life: A review and evaluation of different conceptual approaches. Int J Nurs Stud. 2006;43:891–901.  https://doi.org/10.1016/j.ijnurstu.2006.03.015.CrossRefPubMedGoogle Scholar
  36. 36.
    Spilker B, Revicki DA. Taxonomy of quality of life. In: Spilker B, redactie. Quality of Life and Pharmacoeconomics in Clinical Trials. Philadelphia: Lippincott-Raven Publishers; 1996. pag. 25–31.Google Scholar
  37. 37.
    Arnold R, Ranchor AV, Sanderman R, Kempen GIJM, Ormel J, Suurmeijer TPBM. The relative contribution of domains of quality of life to overall quality of life for different chronic diseases. Qual Life Res. 2004;13:883–96.CrossRefPubMedGoogle Scholar
  38. 38.
    Squires A. Methodological Challenges in Cross-Language Qualitative Research: A Research Review. Int J Nurs Stud. 2009;46:277–87.CrossRefPubMedGoogle Scholar
  39. 39.
    Davis DHJ, Creavin ST, Yip JLY, Noel-Storr AH, Brayne C, Cullum S. Montreal Cognitive Assessment for the diagnosis of Alzheimer’s disease and other dementias (Review). Cochrane Database Syst Rev. 2015;10  https://doi.org/10.1002/14651858.CD010775.pub2.CrossRefPubMedGoogle Scholar
  40. 40.
    Puts MTE, Shekary N, Widdershoven G, Heldens J, Deeg DJH. The meaning of frailty according to Dutch older frail and non-frail persons. J Aging Stud. 2009;23(4):258–66.CrossRefGoogle Scholar
  41. 41.
    Ruikes FGH, Zuidema SU, Akkermans RP, Assendelft WJJ, Schers HJ, Koopmans RTCM. Multicomponent Program to Reduce Functional Decline in Frail Elderly People: A Cluster Controlled Trial. J Am Board Fam Med. 2016;29(2):209–17.CrossRefPubMedGoogle Scholar
  42. 42.
    Almeida Mello J de, Declercq A, Cès S, Van Durme T, Van Audenhove C, Macq J. Exploring Home Care Interventions for Frail Older People in Belgium: A Comparative Effectiveness Study. J Am Geriatr Soc. 2016;64(11):2251–6.CrossRefPubMedGoogle Scholar

Copyright information

© Vilans 2018

Authors and Affiliations

  • Anne van der Vorst
    • 1
  • G. A. Rixt Zijlstra
    • 1
  • Nico De Witte
    • 2
    • 3
  • Ruth G. M. Vogel
    • 4
  • Jos M. G. A. Schols
    • 1
    • 5
  • Gertrudis I. J. M. Kempen
    • 1
  • D-SCOPE Consortium
  1. 1.Department of Health Services Research, Care and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtNederland
  2. 2.Faculty of Psychology and Educational SciencesVrije Universiteit BrusselBrusselBelgië
  3. 3.Faculty of Education, Health and Social WorkHogeschool GentGentBelgië
  4. 4.Research Centre for Community CareZuyd HogeschoolHeerlenNederland
  5. 5.Department of Family Medicine, Care and Public Health Research Institute (CAPHRI)Maastricht UniversityMaastrichtNederland

Personalised recommendations