Objective drivers of subjective wellbeing in geri

Authors: Barbara Bień Katarzyna BieńBarkowska

Publish Date: 2016/07/07

Volume: 25, Issue: 12, Pages: 3047-3056

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Abstract

Identification of optimal predictors for different indicators of subjective wellbeing SWB in geriatric inpatients 1 selfevaluated health status SEH 2 feeling of loneliness FoL and 3 severity of depression symptoms SoDS Investigation of the relationship between response categories of the SWB indicators and their predictorsThe data were collected retrospectively from hospital records All 555 geriatric inpatients underwent a comprehensive geriatric assessment including the Timed Up and Go TUG test The Bayesian information criterion was applied in ordinal logistic regression models to identify optimal predictors of SEH FoL and SoDS among different objective factorsAfter controlling for highstress situations in the recent past motor slowness measured with the TUG test and a level of education were jointly selected as the best predictors of all three SWB indicators The speed of performing the TUG test improved SEH OR = 208 and decreased both FoL OR = 041 and SoDS OR = 041 A higher level of education improved SEH OR = 105 and alleviated both FoL OR = 096 and SoDS OR = 092 Additionally a higher level of SEH was positively correlated with a lower BMI improved instrumental activities of daily living IADL and higher hemoglobin level FoL was reinforced by the level of comorbidity and SoDS was increased by impaired basic ADLAlthough SWB in geriatric inpatients can be explained by objective comorbidities and disabilities the good motor function ie a TUG test outcome of less than about 20 s and a higher level of education were the general predictors that exert an independent beneficial impact on all three SWB indicatorsQuality of life QoL is an umbrella notion that encompasses a plethora of objective and nonobjective factors “that influence what we value in living reaching beyond its material side” 1 Whereas objective elements of QoL eg health employment income skills or education social connections are measurable—or at least confirmable by others—the subjective dimension of QoL ie subjective wellbeing SWB measures how people evaluate the quality of their lives on an internal scale both cognitively and emotionally 2According to the Organisation for Economic Cooperation and Development OECD SWB is defined as “good mental states including all of the various evaluations positive and negative that people make of their lives and the affective reactions of people to their experiences” 3 The complex and multidimensional concept of SWB covers three elements life evaluation a person’s reflective thoughts about life life satisfaction affect a person’s feelings or moods—happiness sadness anger stress and eudaimonia a sense of meaning and purpose in life 3 4 Although all of these aspects refer to the general selfevaluation of life only affect—also known as hedonic wellbeing—expresses internally experienced feelings or intrinsic emotional states that refer to a particular moment in time eg current selfevaluation of health feeling of loneliness depressive mood This element of SWB is largely associated with the subject matter of this articlePositive emotions can trigger the restoration of an individual’s wellbeing an improvement in their broadminded coping skills and can extend the individual’s scope of attention and cognition 5 These emotions promote longevity 6 7 8 and reduce the risk of stroke and other medical conditions 9 10 and depression symptoms predict negative health outcomes in older adults 11 Essentially the willtolive and optimism predict higher survival rates among older people 12 and lower feelings of loneliness 13Geriatric inpatients are usually the most comorbid and the most complicated of all medical cases They are generally portrayed as the “oldest sickest most complicated and frail” inpatients 14 Accordingly multifaceted measurement and operationalization of their SWB is a very challenging task in everyday clinical routine Clinicians usually question their patients about various afflictions and complaints but do not investigate current emotional states of their patients in a structured and indepth manner including their selfevaluation of health SEH feelings of loneliness FoL or the severity of their depression symptoms SoDS Although a comprehensive geriatric care includes an assessment of emotions along with functional status and health conditions in older adults even geriatricians very rarely reach beyond the standard diagnostics of depression However it is known that the positive selfperception of aging may mitigate the negative impact of comorbidity on the quality of life 15

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