What\u27s important in defining quality of life for older people? An exploratory study of the views of older South Australians

Abstract

BackgroundCost-effectiveness analyses of interventions for older adults have traditionally focused on health status. There is&nbsp;increasing recognition of the need to develop new instruments to capture quality of life in a broader sense in the face&nbsp;of age-associated increasing frailty and declining health status, particularly in the economic evaluation of aged and&nbsp;social care interventions which may have positive benefits beyond health.&nbsp;ObjectiveTo explore the relative importance of health and broader quality of life domains for defining quality of life from the&nbsp;perspective of older South Australians.MethodsOlder adults (n=21) from a day rehabilitation facility in Southern Adelaide, South Australia attended one of two audiorecorded&nbsp;focus groups. A mixed methods (qualitative and quantitative) approach was adopted. The study included&nbsp;three main components. Firstly, a general group discussion on quality of life and the factors of importance in defining&nbsp;quality of life. Secondly, a structured ranking exercise in which individuals were asked to rank domains from the brief&nbsp;Older People&rsquo;s Quality of Life questionnaire (OPQOL-brief) and Adult Social Care Outcomes Toolkit (ASCOT) in&nbsp;order of importance. Thirdly, participants were asked to self-complete the Euroqol (EQ-5D) a measure of health&nbsp;status, and two broader quality of life measures: the OPQOL-brief and ASCOT.ResultsMean scores on the EQ-5D, OPQOL-brief and ASCOT were 0.71 (SD 0.20, range 0.06-1.00), 54.6 (SD 5.5, range&nbsp;38-61) and 0.87 (SD 0.13, range 0.59-1.00) respectively, with higher scores reflecting better ratings of QOL. EQ-5D&nbsp;scores were positively associated with OPQOL-brief (rho: .730, p&lt;.01), but not ASCOT. Approximately half (52.4%)&nbsp;of the respondents ranked either &ldquo;health&rdquo; or &ldquo;psychological and emotional well- being&rdquo; as the domain most important&nbsp;to their quality of life. However, one-third (33.3%) of the total sample ranked a non-health domain from the ASCOT or&nbsp;OPQOL-brief (safety, dignity, independence) as the most important contributing factor to their overall quality of life.&nbsp;Qualitative analysis of focus group transcripts supported the high value of both health-related (health, psychological&nbsp;well-being) and social (independence, safety) domains to quality of life.ConclusionsOlder adults value both health and social domains as important to their overall quality of life. Future economic&nbsp;evaluations of health, community and aged-care services for older adults should include assessment of both healthrelated&nbsp;and broader aspects quality of life.</div