Document Type : Original Article
Authors
Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
Abstract
BACKGROUND: This study aimed to identify the quality of life (QoL) and its predictive factors based
on the Andersen’s behavioral model among the elderly in Iran.
MATERIALS AND METHODS: A quantitative cross‑sectional study was conducted on 400 people
aged 60+ resident in Zanjan, Iran, in 2019. Data were collected based on the Andersen’s behavioral
model constructs by the questionnaires. Path analysis was used to determine both direct and indirect
effects of variables and also for estimating the values of coefficients in the underpinning linear model.
RESULTS: In this study, 50% of the participants were female, and 83% were married. The participant’s
QoL was 37.4 (9.8). The results confirmed that financial level and physical activity were the most
significant predictor of the elder’s QoL. Chronic diseases and activities of daily living as need factors
affect the QoL of participant indirectly.
CONCLUSION: The results showed that the participant’s QoL was at a moderate level. Utilizing of
primary health‑care services was the weakest predictors of QoL. Sex, marital status, and education
level were not reliable predictors of QoL in elders. Other predisposing, enabling, and need factors
should be investigated to find the main determinants to improve elder’s QoL.
Keywords
- Maghsoudi A. The study of prevalence of chronic diseases and
its association with quality of life in the elderly of Ewaz (South
of Fars province), 2014. Navid No 2016;18:35‑42.
2. WHO. Ageing and health. Available from: https://www.who.
int/news‑room/fact‑sheets/detail/ageing‑and‑health. [Last
accessed on 2018 Feb 05].
3. Ghadamgahi HB, Norouzi K, Mohammadi F, Jandaqhi J. Stauts
and determiants of health services utilization among elderly rural
hubitants in the Iraninan population. Koomesh 2018;20:779‑85.
4. Aminisani N. A view of ageing from Iran: Introducing the
Iranian Longitudinal Study on Ageing (IRLSA). Innov Aging
2018;2 Suppl 1:73.
5. National Document for the Elderly. Plan and Budget Organization.
Available from: http://www.gums.ac.ir/Upload/Modules/
News/ImageGallery4300/sanad%20melli.pdf. [Last accessed on
2020 Jan 09].
6. Haugan G, Drageset J, André B, Kukulu K, Mugisha J, Utvær BKS.
Assessing quality of life in older adults: Psychometric properties
of the OPQoL‑brief questionnaire in a nursing home population.
Health Qual Life Outcomes 2020;18:1.
7. Sherizadeh Y, Sarkhoshi R, Babazadeh T, Moradi F, Shariat F,
Mirzaeian K. The quality of life and its related factors in the elderly
covered by health care centers in Khoy city, Iran. J Res Clin Med
2016;4:139‑45.
8. Top M, Dikmetaş E. Quality of life and attitudes to ageing in
Turkish older adults at old people’s homes. Health Expect
2015;18:288‑300.
9. Donmez L, Gokkoca Z, Dedeoglu N. Disability and its effects on
quality of life among older people living in Antalya city center,
Turkey. Arch Gerontol Geriatr 2005;40:213‑23.
10. Khaje‑Bishak Y, Payahoo L, Pourghasem B, Asghari Jafarabadi M.
Assessing the quality of life in elderly people and related factors
in Tabriz, Iran. J Caring Sci 2014;3:257‑63.
11. Gallegos‑Carrillo K, García‑Peña C, Durán‑Muñoz C, Mudgal J,
Durán‑Arenas L, Salmerón‑Castro J. Health care utilization and
health‑related quality of life perception in older adults: Astudy of the
Mexican Social Security Institute. Salud Publica Mex 2008;50:207‑17.
12. Moalemi S, Eri M, Sheykholeslami AS, Sadegh Ghelichi A,
Malvandi A. Quality of life and some related factors of elderly
people in Turkmen county, Iran. J Clin Basic Res 2019;3:25‑32.
13. Andersen RM. Revisiting the behavioral model and access to
medical care: Does it matter? J Health Soc Behav 1995;36:1.
14. Andersen R, Davidson P. Measuring access and trends. In:
Changing the US Health Care System. Ch. 1. San Francisco, CA:
Jossey‑Bass Publishers; 1996.
15. Andersen RM. National health surveys and the behavioral model
of health services use. Med Care 2008;46:647‑53.
16. Bakhtiyari F, Foroughan M, Fakhrzadeh H, Nazari N, Najafi B,
Alizadeh M, et al. Validation of the persian version of Abbreviated
Mental Test (AMT) in elderly residents of Kahrizak Charity
Foundation. Iran J Diab Metabol 2014;13:487‑94.
17. Baernholdt M, Hinton I, Yan G, Rose K, Mattos M. Factors
associated with quality of life in older adults in the United States.
Qual Life Res 2012;21:527‑34.
18. Taheri Tanjani P, Azadbakht M. Psychometric properties
of the Persian version of the activities of daily living scale
and instrumental activities of daily living scale in elderly.
J Mazandaran Univ Med Sci 2016;25:103‑12.
19. Heravi‑Karimooi M, Rejeh N, Garshasbi A, Montazeri A,
Bandari R. Psychometric properties of the Persian version of the
quality of life in early old age (CASP‑19). Iran J Psychiatry Behav
Sci 2018;12:e8378.
20. Hyde M, Wiggins RD, Higgs P, Blane DB. A measure of quality
of life in early old age: The theory, development and properties
of a needs satisfaction model (CASP‑19). Aging Ment Health
2003;7:186‑94.
21. Kim HY. Statistical notes for clinical researchers: Assessing normal
distribution (2) using skewness and kurtosis. Restor Dent Endod
2013;38:52‑4.
22. Tomarken AJ, Waller NG. Structural equation modeling:
Strengths, limitations, and misconceptions. Annu Rev Clin
Psychol 2005;1:31‑65.
23. Černovas A, Alekna V, Tamulaitienė M, Stukas R. Reliability and
validity of the lithuanian version of CASP‑19: A quality of life
questionnaire for the elderly. Medicina (Kaunas) 2018;54(6),103.
24. Stoner CR, Orrell M, Spector A. The psychometric properties of the
control, autonomy, self‑realisation and pleasure scale (CASP‑19)
for older adults with dementia. Aging Ment Health 2019;23:643‑9.
25. Adib Hajbagheri M. Geriatic disability related factors. Iran J
Ageing 2008;3:547‑55.
26. Shahbazi MR, Mirkhani M, Hatamizadeh N, Rahgozar M.
Disability assessments in Tehranian elderly, 2007. Iran J Ageing
2008;3:84‑92.
27. MasoumiN, JafroudiS, Ghanbari KhanghahA, Kazemnejad LeiliE.
Assessment of retired elderly’s people autonomy and its affecting
factors in Rasht. J Holistic Nurs Midwifery 2011;21:46‑51.
28. Nazari H, Rashedi V, Mohammadi H, Yousefi M. Relationship
between cognitive status and activities of daily living among
the elderly of nursing homes. J Kermanshah Univ Med Sci
2015;18:744‑46.
29. Kondo N, Kazama M, Suzuki K, Yamagata Z. Impact of mental
health on daily living activities of Japanese elderly. Prev Med
2008;46:457‑62.
30. Sato S, Demura S, Kobayashi H, Nagasawa Y. The relationship
and its change with aging between ADL and daily life satisfaction
characteristics in independent Japanese elderly living at home.
J Physiol Anthropol Appl Human Sci 2002;21:195‑204.
31. Habibi A, Nikpour S, Seiedoshohadaei M, Haghani H. Quality
of life and status of physical functioning among elderly people
in west region of Tehran: A cross‑sectional survey. Iran J Nurs
2008;21:29‑39.
32. Conde‑Sala JL, Portellano‑Ortiz C, Calvó‑Perxas L, Garre‑Olmo J.
Quality of life in people aged 65+ in Europe: Associated factors
and models of social welfare‑analysis of data from the SHARE
project (Wave 5). Qual Life Res 2017;26:1059‑70.
33. McAuley E, Konopack JF, Motl RW, Morris KS, Doerksen SE,
Rosengren KR. Physical activity and quality of life in older
adults: Influence of health status and self‑efficacy. Ann Behav
Med 2006;31:99‑103.
34. Kazemi N, Sajjadi H, Bahrami G. Quality of life in Iranian elderly.
Salmand Iran J Ageing 2019;13:518‑33.
35. Madhvani N, Longinetti E, Santacatterina M, Forsberg BC,
El‑Khatib Z. Correlates of mobile phone use in HIV care: Results
from a cross‑sectional study in South Africa. Prev Med Rep
2015;2:512‑6.
36. Kaptein SA, Badley EM. Sex differences, age, arthritis, and chronic
disease: Influence on physical activity behaviors. J Phys Act
Health 2012;9:540‑8.
37. Marques A, Santos T, Martins J, Matos MG, Valeiro MG. The
association between physical activity and chronic diseases in
European adults. Eur J Sport Sci 2018;18:140‑9.
38. Durstine JL, Gordon B, Wang Z, Luo X. Chronic disease and the
link to physical activity. J Sport Health Sci 2013;2:3‑11. - 39. Fernández‑Olano C, Hidalgo J D , C e r d á ‑ D í a z R ,
Requena‑Gallego M, Sánchez‑Castaño C, Urbistondo‑Cascales L,
et al. Factors associated with health care utilization by the elderly
in a public health care system. Health Policy 2006;75:131‑9.
40. Hasanvand S, Imani‑Nasab MH, Birjandi M, Omidifar R,
Sadegifar J. Utilization of health services among the elderly at
Lorestan province: A cross‑sectional study. Yafteh 2019;21:48‑65.
41. Pourreza A, Khabiri R, Arab M, Akbari Sari A, Rahimi A, Toll A.
Healthcare‑seeking behavior in Tehran, Iran and factors affecting
it. J Schl Public Health Institute Public Health Res 2009;7:1‑13.
42. Wang Q, Bourbeau J. Outcomes and health-related quality of life
following hospitalization for an acute exacerbation of COPD.
Respirology 2005;10:334‑40.
43. Schoofs N, Bambini D, Ronning P, Bielak E, Woehl J. Death of a
lifestyle: The effects of social support and healthcare support on
the quality of life of persons with fibromyalgia and/or chronic
fatigue syndrome. Orthop Nurs 2004;23:364‑74.
44. Gleich GS. Health maintenance and prevention in the elderly.
Prim Care 1995;22:697‑711.
45. Yazdanpoor F, Sam Arm E. Factors related to the quality of life of
the elderly (elderly people in Khomein city). Soc Develop Welfare
Planning. 2011:5(3).45‑64.