Quality of Life

Psychometric testing of the multidimensional older people's quality of life (OPQOL) questionnaire and the causal model of QoL under-pinning it

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There are now more people aged in their 70s and 80s, and with increased life expectancy, than ever before (http:// www.statistics.gov.uk/focuson/olderpeople).

Increasing social expectations, and concerns about the policy implications of the ageing population, have led to interest in improving older people’s health, independence, activity, social and economic opportunities and participation, thereby their active contribution to society, and, in effect, adding quality to extended years.

Investigator(s)

  • Ann Bowling, University College London
  • David Banister, University of Oxford
  • Paul Stenner, University of Brighton
  • Kerry Sproston, National Centre for Social Research
  • Helena Titheridge, University College London

Team

  • Mr Charlie Clerke, Enfield PCT
  • Chris Bain, Age Concern England

Contact details

Ann Bowling

Background

  • There are now more people aged in their 70s and 80s, and with increased life expectancy, than ever before (http:// www.statistics.gov.uk/focuson/olderpeople).
  • Increasing social expectations, and concerns about the policy implications of the ageing population, have led to interest in improving older people’s health, independence, activity, social and economic opportunities and participation, thereby their active contribution to society, and, in effect, adding quality to extended years.

  • Assessment of the effectiveness of public policy in this area requires the use of relevant and valid measurement instruments, based on a sound conceptual model and with relevance to older people.

Aims/objectives

  1. Test a new measure of Older People's Quality of Life (OPQOL);

  2. The robustness of the causal model under-pinning it as people age;

  3. Thereby providing detailed information on the dynamic links between influences on quality of life (QoL), the process of active ageing and the outcome of self-assessed QoL.

Design

Three vehicles will be used:

  1. A national Omnibus Survey will be used to test the reliability and validity of the OPQOL. This is a rolling survey of adults aged 16+, based on a stratified random sample of postcodes across Britain. People aged 65 and over, who are representative of older people living at home in Britain will be sifted and interviewed face-to-face at home;

  2. The Ethnibus face-to-face home interview survey will be used to assess whether the OPQOL is psychometrically sound among ethnically diverse populations. The questionnaire and its domains will initially be assessed with three focus groups reflecting ethnic diversity. People aged 65 and over, will be sifted and interviewed face-to-face at home;

  3. In order to test the reliability and validity of the measure dynamically as people age, the OPQOL will be administered in a postal follow-up of our QoL Survey respondents (1999/2000 baseline survey funded by ESRC Growing Older Programme), with further qualitative follow-up of a sub-sample.

Policy implications

Our research is intended to be of value to policy makers across sectors and academics. A key policy and practical implication is the testing of the psychometric properties of the Older People’s Quality of Life Questionnaire (OPQOL).

Product development:

The product development opportunity, and end-product of the research, therefore, is the fully tested, multidimensional measurement tool, appropriate for use in the evaluation of multi-sector policy on ageing, and in descriptive research monitoring QoL in older age.

Other policy and practice implications of the research:

The research will also examine older people’s perceptions, and self-assessments, of active ageing, and associations with quality of life. Comparisons will be made with existing definitions and policy agendas. Older people’s perceptions have been neglected in the policy and academic literature. There is an expectation in the policy literature that active ageing can be promoted by health promotion and physical activity prescriptions, while the theoretical literature indicates that self-efficacy may be a mediating variable between activity interventions and QoL. The role of self-efficacy in ‘active ageing’ requires examination longitudinally, and has implications for chronic disease management programmes for those who are ill or frail (i.e. supporting self-efficacy training) as well as for exercise prescriptions (i.e. motivating feedback to promote self-efficacy). We intend to explore whether self-efficacy is associated with ‘activity’ in older age groups (using both lay and published definitions), and thereby to enhanced QoL, dynamically. Active ageing has also been defined in terms of social participation. At baseline, using multi-level modelling, we found that area affluence, respondents' perceptions of neighbourliness of the area, and ratings of facilities, independently influenced respondents' levels of social activity; social activity, in turn, was associated with enhanced QoL. If the associations hold longitudinally, the policy implication is that strategies that aim to promote the social activity element of active ageing, and thereby enhanced QoL, need to ensure that local infrastructures include facilities which older people feel include them, and designs which aim to enhance perceived 'neighbourliness'.

Non-academic involvement:

We will liaise closely with our non-academic partners, who include Age Concern England, management and policy representation, and older people themselves. We will work with the NDA programme to maximise the impact of the study, and will be pro-active in the dissemination of the results to stakeholders across policy sectors.

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