Health and Quality of Life: health factors affecting self-perception of health and satisfaction with health in old age

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

Congreso; XII International Symposium in Medical Geography; 2007

Introduction: A great agreement exists in the literature about the relevance of health in quality of life. In an empirical study 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, health self-perception and satisfaction with health are widely used in health questionnaires. Aim: To search health factors explaining self-perception of health and satisfaction with health, under the hypothesis that both variables represent different attributes. Data source: The data come from a wider research on Overall Quality of Life in Old 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: Principal Component Analysis procedure was applied to reduce the dimensionality of the original variables related to: (i) health conditions (morbidity, disability/functional capability, pain/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 independent variables in two Multiple Linear Regression Analyses, in order to explain health self-perception and satisfaction with health, respectively. Results: Self-perception of health was predicted by 10 factors. The first five components (46% of the explained variance) include information related to primary and specialized health services use, EuroQol-5D measures, comorbidity, depression, physical functioning, and satisfaction with dental services. Concerning 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-5D related to health perception, and genitourinary disorders. Discussion and Conclusions: Self-perceived health and satisfaction with health are both explained by objective and subjective health 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 health self-perception. 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 with health are likely to be associated with high levels of satisfaction with memory and conversational abilities, and with diet and sleep. These findings indicate that both subjective variables represent different aspects of health and should be used for different purposes.