Psychological and physical wellness in older adults from the patient perspective

Abstract

The authors of this study examined the relation-ship between life attitude and physical disease state and found that psychological well being me-diated patients' illness course. Coherence and life control were endorsed as the important compo-nents of psychological well being. A multi-dimen-sional measure of life purpose was administered to 97 older adults on the acute rehabilitation unit of a major medical center in the United States. The severity of their illness burden was compu-ted blindly by a physician rater. Regression ana-lysis was conducted to determine if life attitude was predictive of the symptom ratings and factor analysis was performed on the individual items of the life attitude instrument to highlight the psy-chological profile of the older adults in this study for whom health challenges were primary. There was a significant relationship between life attitude and disease severity, even though the fit of the model indicated the need for other expla-natory factors to fully account for sickness. Fac-tor analysis demonstrated that items defined as measuring coherence and life control explained the largest proportion of total variance. Coher-ence incorporated the logical integration and con-sistent understanding of one's self and the world at large. Life control referred to volition in deci-sion making, exercising of personal responsibi-lity, and the unfolding of life events. The findings suggested that in older adults undergoing medi-cal hospitalization, psychological resilience had a retrospective orientation rather than prospec-tive. The significant influence of life attitude on patients' physical condition was consistent with clinical observations that the patients who resi-liently endure health challenges seem to possess a hardy psychological reserve.