Academic journal article British Journal of Occupational Therapy

Relationship between Interests and Health-Related Quality of Life in Older People

Academic journal article British Journal of Occupational Therapy

Relationship between Interests and Health-Related Quality of Life in Older People

Article excerpt

Introduction

Supporting high quality of life (QoL) for community-dwelling older individuals is the ultimate goal of the current welfare policy in Japan. QoL in this population correlates with independent living state; that is, activities of daily living (ADL) performed without intervention from welfare services. Independent living in communities involves a wide range of ADL. Personal ADL covers all personal care activities, including taking medication and managing personal hygiene, and domestic ADL includes daily chores such as cooking, cleaning and doing the washing. To determine the level of independence, individuals are assessed in the following six categories: physical functions, eating-related functions, such as chewing and swallowing, nutrition status, depression, dementia and propensity towards being housebound. Japanese health professionals are required to provide group programmes to promote healthy living and to help community-dwelling older individuals to avoid falling into a dependent living state (Ministry of Health, Labour and Welfare 2006).

Moreover, occupational therapists have assessed QoL in older individuals through expressions of client satisfaction. Previous studies reported an association between life satisfaction and interests among institutionalised older individuals (Gregory 1983, Smith et al 1986, Watts et al 1986). Interest is generated through the experience of pleasure and satisfaction in an occupation (Kielhofner 2009). Assessing interests is essential to determine QoL and satisfaction. Therefore, the Japanese Interest Checklist for the Elderly (JICE; Yamada et al 2002) was developed.

The JICE is based on Matsutsuyu's checklist (1969), which is the classic interest checklist most often used in occupational therapy. Participants are required to indicate strong, casual or no interest in the listed 80 activities. The checklist provides an opportunity to specify other activities not listed in it. Two surveys were conducted to determine interest responses in a sample of 253 older Japanese individuals. The JICE lists 29 culturally and developmentally appropriate activities that captured the interest responses to those surveys in this older Japanese population.

Because the factorial structure of the JICE was based on items from Matsutsuyu's checklist (1969), a factor analytic study of the JICE was conducted using data from 967 community-dwelling healthy older Japanese individuals (Nakamura-Thomas and Yamada 2011). The study identified the following factors in the JICE: ADL, Pleasurable Outings, Cultural/Educational Activities, Entertainment Activities, Nature-related Activities and Social Activities. The ADL factor in the JICE included dusting/laundry, cooking, shopping, sewing and personal care. Pleasurable Outings included travelling, driving, attending Japanese-style parties, socialising with the opposite gender and visiting acquaintances. Cultural/ Educational Activities included reading, enjoying literature activities, discussing politics, attending lectures, collecting things and listening to the radio. Entertainment Activities included singing, listening to music and watching television/ movies. Nature-related Activities included gardening/growing vegetables, taking care of pets or animals and picking wild plants. Social Activities included playing gate-ball, playing ground-golf and attending club meetings for women/older people. The study provided reliability evidence of the five factors other than Social Activities across genders and two age groups (65-74 years and > 75 years).

As a comprehensive health-related QoL measurement instrument, the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) has been used internationally (Fukuhara et al 1998). The SF-36 provides scores on eight subscales: Physical functioning, Role limitations due to physical issues, Bodily pain, General health perceptions, Vitality, Social functioning, Role limitations due to emotional issues and Mental health. …

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