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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2020

Open Access 01-12-2020 | Care | Research

Assessing quality of life in older adults: psychometric properties of the OPQoL-brief questionnaire in a nursing home population

Authors: Gørill Haugan, Jorunn Drageset, Beate André, Kamile Kukulu, James Mugisha, Britt Karin S. Utvær

Published in: Health and Quality of Life Outcomes | Issue 1/2020

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Abstract

Background

Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties.

Methods

Cross-sectional data were collected during 2017–2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority’s decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed.

Results

Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items.

Conclusion

Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.
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Literature
1.
World Health Organization. World report on ageing and health. 2018 2018, February 5th 2019, July 17th].
2.
Kinsella K, He W. An Aging World: 2008, U.C. bureau, editor. Washington, DC: U.S. Department of Health and Human Services National Institutes of Health NATIONAL INSTITUTE ON AGING U.S. Department of Commerce economics and statistics; 2009. p 1-191.
3.
The WHOQOL Group, W., Development of the World Health Organization WHOQOL-BREF quality of life assessment. The WHOQOL Group. Psychol Med., 1998;28(3): p. 551–8.
4.
Bowling, A., Measuring health: a review of quality of life measurement scales. third ed. 2004, Maidenhead, GB. : Open University. 224.
5.
Cooney A, et al. Exploration of the meaning of connectedness for older people in long-term care in context of their quality of life: a review and commentary. Int J Older People Nursing. 2014;9(3):192–9.CrossRef
6.
Bredle JM, et al. Spiritual well-being as a component of health-related quality of life: the functional assessment of chronic illness therapy—spiritual well-being scale (FACIT-Sp). Religions. 2011;2(1):77–94.CrossRef
7.
Chirico F. Spiritual well-being in the 21st century: it is time to review the current WHO’s health definition. J Health Soc Sci. 2016;1(1):11–6.
8.
Dhar N, Chaturvedi S, Nandan D. Spiritual Health Scale 2011: Defining and Measuring 4th Dimension of Health. Indian J Community Med. 2011;36(4):275–82.PubMedPubMedCentralCrossRef
9.
Bradshaw SA, Playford ED, Riazi A. Living well in care homes: a systematic review of qualitative studies. Age Ageing. 2012;41(4):429–40.PubMedCrossRef
10.
Haugan G. Nurse-patient interaction is a resource for hope, meaning-in-life, and self-transcendence in cognitively intact nursding-home patients. Scand J Caring Sci. 2014;2014(28):74–8.CrossRef
11.
Haugan G. Meaning-in-life in nursing-home patients: a valuable approach for enhancing psychological and physical well-being? J Clin Nurs. 2014;23(13–14):1830–44.PubMedCrossRef
12.
Haugan, G., et al., Development and psychometric properties of the joy-of-life scale among cognitively intact nursing home patients. Scand J Caring Sci, 2019.
13.
Drageset J, Haugan G, Tranvåg O. Crucial aspects promoting meaning and purpose in life: perceptions of nursing home residents. BMC Geriatrics, Open Access. 2017;17(1):254.CrossRef
14.
Duggleby W, et al. Hope, older adults, and chronic illness: a metasynthesis of qualitative research. J Adv Nurs. 2012;68(6):1211–23.PubMedCrossRef
15.
Hammer KOEOC. The meaning of hope in nursing research: a meta-synthesis. Scand J Caring Sci. 2009;23(3):549–57.PubMedCrossRef
16.
Reed PG. Theory of self-transcendence, in Middle range theory for nursing. In: Smith MJ, Liehr PR, editors. . New York: Springer Pub; 2018. p. 119–46.
17.
Haugan G, et al. Self-transcendence in nursing home patients - a resource for well-being. J Adv Nurs. 2013;69(5):1147–60.PubMedCrossRef
18.
19.
Barca ML, et al. Factors associated with depression in Norwegian nursing homes. Int J Geriatr Psychiatry. 2009;24(4):417–25.PubMedCrossRef
20.
Haugan G. Meaning-in-life in nursing-home patients: a correlate to physical and emotional symptoms. J Clin Nurs. 2014;23(7–8):1030–43.PubMedCrossRef
21.
World Health Organization. Global status report on noncommunicable diseases 2010. 2011. p. 176. ISBN: 978 92 4 156422 9.
22.
Bowling A, et al. A short measure of quality of life in older age: the performance of the brief older People's quality of life questionnaire (OPQOL-brief). Arch Gerontol Geriatr. 2013;56(1):181–7.PubMedCrossRef
23.
American Psychological Association and National Council on Measurement in Education. Standards for educational and psychological testing. Washington, DC: American Educational Research Association; 1999.
24.
Goodwin LD, Leech NL. The meaning of validity in the new standards for educational and psychological testing: implications for measurement courses. Meas Eval Couns Dev. 2003;36(3):181–92.CrossRef
25.
Netemeyer R, Bearden W, Sharma S. Scaling procedures. Issues and Applications. In: Thousand oaks. London, New Dehli: SAGE Publications, Inc.; 2003.
26.
Ginty, A.T., Psychometric Properties, in Encyclopedia of Behavioral Medicine, G. M.D. and T. J.R., Editors. 2013, Springer: New York, NY.CrossRef
27.
Haugan G. The relationship between nurse-patient-interaction and meaning-in-life in cognitively intact nursing-home patients. J Adv Nurs. 2014;70(1):107–20.PubMedCrossRef
28.
Haugan G, Moksnes UK, Espnes GA. Nurse-patient-interaction: a resource for hope among cognitively intact nursing home patients. J Holist Nurs. 2013;31(3):152–63.PubMedCrossRef
29.
Haugan, G., Self-transcendence, well-being and nurse-patient interaction in cognitively inatct nursing home patients, in Faculty of Social Sciences and Technology Management, Department of Social Work and Health Science. 2013, Norwegian University of science and technology: Trondheim, Norway p 88.
30.
Haugan G, Hanssen B, Moksnes UK. Self-transcendence, nurse-patient interaction and the outcome of multidimensional well-being in cognitively intact nursing home patients. Scand J Caring Sci. 2013;27(4):882–93.PubMedCrossRef
31.
Haugan G, et al. Self-transcendence and nurse-patient interaction in cognitively intact nursing-home patients. J Clin Nurs. 2012;21:3429–41.PubMedCrossRef
32.
Haugan G, Moksnes UK, Løhre A. Intra-personal self-transcendence, meaning-in-life and nurse-patient interaction: powerful assets for quality of life in cognitively intact nursing home patients. Scand J Caring Sci. 2016;30(4):790–801.PubMedCrossRef
33.
Drageset J, et al. Sense of coherence as a resource in relation to health-related quality of life among mentally intact nursing home residents - a questionnaire study. Health Qual Life Outcomes. 2008;6:85.PubMedPubMedCentralCrossRef
34.
Drageset J, et al. Emotional loneliness is associated with mortality among mentally intact nursing home residents with and without cancer: a five-year follow-up study. J Clin Nurs. 2013;22(1–2):106–14.PubMedCrossRef
35.
Drageset J, et al. The impact of social support and sense of coherence on health-related quality of life among nursing home residents--a questionnaire survey in Bergen, Norway. Int J Nurs Stud. 2009;46(1):66–76.CrossRef
36.
Haugan G, Innstrand ST, Moksnes UK. The effect of nurse-patient-interaction on anxiety and depression in cognitively intact nursing home patients. J Clin Nurs. 2013;22(15–16):2192–205.PubMedCrossRef
37.
Haugan, G. and S.T. Innstrand, The effect of self-transcendence on depression in cognitively intact nursing home patients. ISRN Psychiatry, 2012. 2012(Article ID 301325): p. 10.
38.
Drageset J, Espehaug B, Kirkevold M. The impact of depression and sense of coherence on emotional and social loneliness among nursing home residents without cognitive impairment - a questionnaire survey. J Clin Nurs. 2012;21(7–8):965–74.PubMedCrossRef
39.
Waltz CF, Strickland OL, Lenz ER. Measurement in nursing and health research. 3rd ed. New York: Springer; 2005.
40.
Clark LA, Watson D. Constructing validity: basic issues in objective scale development. Psychol Assess. 1995;73:309–19.CrossRef
41.
Bowling A, Gabriel ZL. Theories of Quality of Life in Older Age. Aging Soc. 2007;27(827–48).
42.
Bowling, A. And S. P., Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD. J Epidemiol Community Health, 2010. 65: p. 273–280.PubMedPubMedCentralCrossRef
43.
Bowling, A., Psychometric properties of the older People’s quality of life questionnaire validity. Curr Gerontol Geriatr Res, 2009. 298950.
44.
Bowling A, Stenner P. Which measure of quality of life performs best in older age? A comparison of the OPQOL, CASP-19 and WHOQOL-OLD. J Epidemiol Community Health. 2011;65:273–80.PubMedCrossRef
45.
Bilotta C, et al. Dimensions and correlates of quality of life according to frailty status: a crosssectional study on community-dwelling older adults referred to an outpatient geriatric service in Italy. Health Qual Life Outcomes. 2010;8(56).PubMedPubMedCentralCrossRef
46.
Bilotta C, et al. Older People’s Quality of Life (OPQOL) scores and adverse health outcomes at a one-year follow-up. A prospective cohort study on older outpatients living in the community in Italy. Health Qual Life Outcomes. 2011;9(72).PubMedPubMedCentralCrossRef
47.
Bilotta C, et al. Quality of life in older outpatients living alone in the community in Italy. Health Soc Care Commun. 2012;20:32–41.CrossRef
48.
Mares J, Cigler H, Vachkova E. Czech version of OPQOL-35 questionnaire: the evaluation of the psychometric properties. Health Qual Life Outcomes. 2016;14(93).
49.
Chen Y, Hicks A, While A. Validity and reliability of the modified Chinese version of the Older People's Quality of Life Questionnaire (OPQOL) in older people living alone in China. Int J Older People Nursing. 2014;9(4):306–16.CrossRef
50.
Hendricson W, et al. Development and initial validation of a dual-language English-Spanish format for the arthritis impact measurement scales. Arthritis Rheum. 1989;32:1153–9.PubMedCrossRef
51.
Beaton, D., et al., Recommendations for the Cross-Cultural Adaptation of the DASH and Quick DASH Outcome Measures. 2007, Toronto: : Institute for Work and Health.
52.
Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. J Clin Epidemiol. 1993;46:1417–32.PubMedCrossRef
53.
Reed, P.G., Theory of Self-Transcendence, in Middle Range Theory for Nursing, M.J. Smith and P.R. Liehr, Editors. 2008, Springer publishing company, LLC: New York p 105-129.
54.
Reed PG. Demystifying self-transcendence for mental health nursing practice and research. Arch Psychiatr Nurs. 2009;23(5):397–400.PubMedCrossRef
55.
Reed PG. Toward a nursing theory of self-transcendence: deductive reformulation using developmental theories. Adv Nurs Sci. 1991;13(4):64–77.CrossRef
56.
Haugan G, et al. The self-transcendence scale - an investigation of the factor structure among nursing home patients. J Holist Nurs. 2012;30(3):147–59.PubMedCrossRef
57.
Crumbaugh JC. Cross-validation of purpose-in life test based on Frankl's concepts. J Individ Psychol. 1968;24:74–81.PubMed
58.
Crumbaugh JC, Henrion R. The PIL test: administration, interpretation, uses theory and critique. Int Forum Logother. 1988;11(2):76–88.
59.
Crumbaugh JC, Maholick LT. An experimental study in existentialism: the psychometric approach to Frankl’s concept of noogenic neurosis. J Clin Psychol. 1964;20(2):200–7.PubMedCrossRef
60.
Crumbaugh JC, Maholick LT. Manual of Instructions for The Purpose-in-life test. Psychometric Affilitates, in Viktor Frankl Institute of Logotherapy 1969. 1981.
61.
Crumbaugh JC, Maholick LT. Manual of Instructions for the Purpose-in-Life Test. Illinois: Psychometric Affiliates: (P.O. Box 2852, Saratoga, CA 95070) Murfreesboro: Psychometric Affiliates; 1969.
62.
Steger MF. An illustration of issues in factor extraction and indentification of dimensionality in psychological assessment data. J Pers Assess. 2006;86:263–72.PubMedCrossRef
63.
Steger MF, et al. The meaning in life questionnaire: assessing the presence of and search for meaning in life. J Couns Psychol. 2006;53:80–93.CrossRef
64.
Bondevik, M., The Life of the Oldest Old. Studies concerning loneliness, social contacts, activities of daily living, purpose in life and religiousness, in Department of Public Health and Primary Health Care, Division for Nursing Science. 1997, University of Bergen: Bergen.
65.
Bondevik M, Skogstad A. Loneliness, religiousness, and purpose in life in the oldest old. J Relig Gerontol. 2000;11(1):5–21.CrossRef
66.
Haugan G, Moksnes UK. Meaning-in-life in nursing-home patients: a validation study of the purpose-in-life test. J Nurs Meas. 2013;21(2):296–319.PubMedCrossRef
67.
Flood M, Scharer K. Creativity enhancement: possibilities for succesful aging. Issues Ment Health Nurs. 2006;27:939–59.PubMedCrossRef
68.
Haugan, G., et al., Development and psychometric properies of the joy-of-life scale in cognitively intact nursing home patients. Scand J Caring Sci, 2019.
69.
Keyes, C.L., Mental health as a complete state: how the salutogenic perspective completes the picture in Bridging Occupational, Organizational and Public Health, G.F. Bauer and O. Hämmig, Editors. 2014, Springer: Netherlands. p. 179–92.
70.
Keyes CL. Promoting and protecting mental health as flourishing: a complementary strategy for improving national mental health. Am Psychol. 2007;62(2):95–108.PubMedCrossRef
71.
Keyes CL, Lopez SJ. Toward a science of mental health. In: Snyder CR, Lopez SJ, editors. Oxford handbook of positive psychology. Oxford: Oxford University Press; 2009. p. 89–95.
72.
Seligman M. Flourish: a visionary new understanding of happiness and well-being. New York: Simon and Schuster; 2012.
73.
74.
Watson, J., Nursing: human science and human care. A theory of nursing. 1988, New York: National League for Nursing.
75.
Nåden D, Sæteren B. Cancer patients’ perception of being or not being confirmed. Nurs Ethics. 2006;13(3):222–35.PubMedCrossRef
76.
Watson J. Watson's theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice. Texto Contexto - Enferm. 2017;16:129–35.CrossRef
77.
Rinnan E, et al. Joy of life in nursing homes: a qualitative study of what constitutes the essence of joy of life in elderly individuals living in Norwegian nursing homes. Scand J Caring Sci. 2018.
78.
Haugan G, Drageset J. The hospital anxiety and depression scale—dimensionality, reliability and construct validity among cognitively intact nursing home patients. J Affect Disord. 2014;165:8–15.PubMedCrossRef
79.
StataCorp. Stata: Release 16. Statistical Software. College Station: StataCorp LLC; 2019.
80.
Hurley AM, et al. Exploratory and confirmatory factor analysis: guidelines, issues, and alternative. J Organ Behav. 1997;18:667–83.CrossRef
81.
Brown T. Confirmatory factor analysis for applied research. New York: The Guilford Press; 2006.
82.
Sharma S. Applied multivariate techniques. New York: Wiley; 1996.
83.
Tabachnick BG, Fidell LS. Using Multivariate Statistics. 7th ed. Harlow: Pearson Education Inc; 2019.
84.
Mehmetoglu, M. and T.G. Jakobsen, Applied Statistics using STATA. A guide for the social sciences. 2017, Los Angelos - London - New Dehli - Singapore - Washington DC - Melbourne: SAGE.
85.
Mehmetoglu, M. and T. Jakobsen, Applied Statistics using STATA. A guide for the social sciences. 2017, Los Angelos - London - New Dehli - Singapore - Washington DC - Melbourne: SAGE.
86.
Acock AC. Discovering structural equation modeling using Stata revised ed. Texas: STATA Press; 2013.
87.
Satorra A, Bentler P. Corrections to Test Statistics and Standard Errors in Covariance Structure Analysis. In: Von Eye A, Cloggs C, editors. Latent variables analysis: Applications for developmental research. Thousand Oaks: Sage; 1994. p. 399–419.
88.
Kline R. In: Little TD, editor. Principles and Practice of Structural Equation Modeling. 3rd ed. New York: The Guildford Press; 2011.
89.
Osborne, J.W. and A.B. Costello, Best Practices in Exploratory Factor Analysis: Four Recommendations for Getting the Most From Your Analysis. Practical Assessment, Research & Evaluation, 2005. 10(7, July 2005): p. 1–9.
90.
Hair Jj, et al. Multivariate data analysis. Upper Saddle River: Prentice Hall; 2010.
91.
Fabrigar LR, et al. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;3:272–99.CrossRef
92.
Nunally JC, Bernstein IH. Psychometric theory. New York: McGraw-Hill; 1994.
93.
Raykov T. Estimation of congeneric scale reliability using covariance tructure analysis with nonlinear constraints. Br J Math Stat Psychol. 2001;54(2):315–23.PubMedCrossRef
94.
Fayers P, Machin D, editors. Quality of Life. The assessment, analysis and interpretation of patient-reported outcomes. 2nd ed. Chisester: John Wiley & Sons Ltd.; 2007.
95.
Slettebo A, et al. The significance of meaningful and enjoyable activities for nursing home resident's experiences of dignity. Scand J Caring Sci. 2017;31(4):718–26.PubMedCrossRef
96.
Grönstedt H, et al. Effects of individually tailored physical and daily activities in nursing home residents on activities of daily living, physical performance and physical activity level: a randomized controlled trial. Gerontol. 2013;59(3):220–9.CrossRef
97.
Brownie S, Horstmanshof L. Creating the conditions for self-fulfilment for aged care residents. Nurs Ethics. 2012:1–10.
98.
Haugland BØ. Meningsfulle aktiviteter på sykehjemmet [Meaningful activities in nurisng homes]. Sykepleien Forskning. 2012;7(1):42–9.
99.
Harper Ice G. Daily life in a nursing home - has it changed in 25 years? J Aging Stud. 2002;16:345–59.CrossRef
100.
FABBRI E, et al. Aging and Multimorbidity: New Tasks, Priorities, and Frontiers for Integrated Gerontological and Clinical Research. J Am Med Dir Assoc. 2015;16(8):640–7.PubMedPubMedCentralCrossRef
101.
Otsuka S, et al. Prospects for introducing the Eden Alternative to Japan. J Gerontol Nurs. 2010;36(3):47–55.PubMedCrossRef
102.
Choi N, Ransom S, Wyllie R. Depression in older nursing home residents: the influence of nursing home environmental stressors, coping, and acceptance of group and individual therapy. Aging Ment Health. 2008;12(5):536–47.PubMedCrossRef
103.
Tuckett A. The meaning of nursing-home: ‘waiting to go up to St. Peter, OK! Waiting house, sad but true’: an Australian perspective. J Aging Stud. 2007;21(2):119–33.CrossRef
104.
Bergland A, Kirkevold M. Thriving in nursing homes in Norway: contributing aspects described by residents. Int J Nurs Stud. 2006;43(6):681–91.PubMedCrossRef
105.
Bergland A, Kirkevold M. Resident-caregiver relationships and thriving among nursing home residents. Res Nurs Health. 2005;28(5):365–75.PubMedCrossRef
106.
Bollen KA. Structural equations with latent variables. New York: Wiley; 1989.CrossRef
Metadata
Title
Assessing quality of life in older adults: psychometric properties of the OPQoL-brief questionnaire in a nursing home population
Authors
Gørill Haugan
Jorunn Drageset
Beate André
Kamile Kukulu
James Mugisha
Britt Karin S. Utvær
Publication date
01-12-2020
Publisher
BioMed Central
Keyword
Care
Published in
Health and Quality of Life Outcomes / Issue 1/2020
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-019-1245-3

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