The meaning of health in self-perceived health status and in satisfaction with health among older people

FERNANDEZ-MAYORALAS, G.; PRIETO FLORES, M.E.; ROJO-PEREZ, F.; LARDIÉS BOSQUE, R.; RODRIGUEZ-RODRIGUEZ, V.; ROJO-ABUIN, J. M.

Congreso; The 2007 ISQOLS Conference (From Quality of Life Concepts to Quality of Life Performance Measures); 2007

Introduction; A great agreement exists in the literature about the relevance of health in quality of life. In an empirical stutdy in aged people, we found that health was, in absolute and relative terms, the most important self-nominated domain to define their Quality of Life. From a Quality of Life research perspective, objective and subjective indicators are recommended  to be included to study each dimension and their contribution to Quality of Life. Among the subjective indicators within health domain, perception of health status and satisfaction with health are widely used in health questionnaires.Aims: The objective of the paper is to search health factors explaining self­perceived health status and satisfaction with health, under the hypothesis that both variables are explained by different attributes and should be used together to explain the meaning of health in Quality of Life.Data source: The data come from a wider research on Overall Quality of Life inOld Age, using a survey carried out in 2005, with a representative sample of 499 people aged 65 and over, living in family housing in the Madrid Region (Spain)Methods: Correspondence Analysis was applied on self-perceived health status and satisfaction with health towards obtaining a synthetic variable on subjective health. Besides, Principal Component Analysis procedure was applied to reduce the dimensionality of the original variables related to: (i) health conditions (morbidity, disability/functional ability, discomfort); (ii) health promotion (habits related to tobacco and alcohol consumption, diet and sleep, physical and mental activities, memory and conversational abilities); and (iii) health services use. Twenty seven factors were obtained and used as indepcndent variables in Multiple Linear Regression Analyses (MLRA) in order to explain self-perceived health, satisfaction with health and the synthetic subjective health variable, respectively.Results: Self-perception of health was predicted by lO factors. The first five components (46% of the explained variance) include information related to primary and specialized health services use, EuroQol-50 measurcs, comorbidity, depression, physical functioning and satisfaction with dental scrvices. Conceming satisfaction with health, it was predicted by 8 factors. In this case, the first five components (48% of the explained variance) include information on satisfaction with memory and conversational abilities, satisfaction with diet and sleep, depression, those measures of EuroQol-50 related to health perception, and genitourinary disorders. In relation to the synthetic information on subjective health, the model was formed by 15 factors, among which the first five (51% ofthe explained variance) include information on EuroQol-50 measures, comorbidity, depression, satisfaction with memory and conversational abilities, physical functioning, and suffering tumour.Discussion and Conclusions: Self-perceived health and satisfaction with healthare both explained by objective and subjective indicators. Even though, it seems that key indicators of the objective health conditions, i.e. health services use, comorbidity and physical functioning, have a greater influence on the explaining model of self­perceived health status. In this sense, the model suggests that low levels of comorbidity, depression and health services use, together with a good functional ability, contribute to a better self-perceived health. In relation to the satisfaction with health, it seems that subjective evaluations based on satisfaction contribute in a greater extent in the explanation of this dependent variable. Accordingly, high levels of satisfaction withhealth are likely to be associated with high levels of satisfaction with memory and conversational abilities, and with diet and sleep. Regarding the synthetic subjective health variable, the main factors include both, objective and subjective information on health, achieving a model wil11 a higher explained variance. These findings indicate that both subjective health variables, self-perceived health status and satisfaction with health, represent different aspects and should be used together to better explain the meaning of health in Quality of Life.