Health related quality of life among the elderly in Taiwan.

Abstract

The structural and social changes impacting on Taiwan, particularly the aging of the population, decreasing number of children who can take care of older parents, changing life style and health needs call for a periodic assessment of the health related quality of life (HRQoL) of older people. However, the conceptualization and measurement of HRQoL is not well established. To address these issues, this study was conducted. The purposes of this study were: (a) to develop a multidimensional model of perceived HRQoL in the elderly; (b) evaluate the model on a data set from Taiwan; and (c) examine the influences of social support, age, gender, education, ethnicity, and marital status on the dimensions of HRQoL. Findings from this study lend support to the hypothesized linkages of the dimensions of HRQoL model in that chronic illness, functional status, and mental health are functions of self-rated health, and chronic illness and functional status influence mental health. The data support the structural model of HRQoL very well as indicated by several goodness-of-fit indices. The parameter estimates of all components, except constrained parameters were all highly significant. Furthermore, the convergence of findings from two randomly divided sub-samples provides evidence of the validity of the four dimensional model of HRQoL. An expanded model of HRQoL with social support variables, age, gender, education, marital status and ethnicity was formulated and evaluated. This model was also supported empirically both in terms of goodness-of-fit and parameter estimates. Education had the most significant influence on health and social support variables. Age had a significant influence on all dimensions of HRQoL except mental health. Family and other network were sources of emotional support and had significant influences on mental health. The effects of marital status and ethnicity on HRQoL and social support were somewhat inconclusive. Older women, the less educated and Mainlanders tended to have some deficits in HRQoL. Theoretical and applied implications of the study findings were discussed.