Aging perceptions of the elderly and the related factors about health related quality of life

INTRODUCTIONPerceived health concerns with the old age because of increased cronical diseases and caused health problems, decreased activity and increased dependency, the limited environmental correspendence , psychological problems caused by aging and the idea of getting to the end of life.PURPOSEThe aim of this study was to define the olds properties, health perceptions,aging perceptions and attitudes to aging,and to figure out the variables effecting the aging perception and health quality of the olds, living in the rural, urban, and in the periurban sitesMATERİALS AND METHODThis was a cross sectional study progressed at the Muradiye Health center district (rural),Barbaros health center district(preurban) and 10 no. Health center district(urban). The population of the study was 2596 olds. For calculating the sampling size and choosing the sample simple random group sampling method was used. The sample size was 510,and the contribution rate was %69.6. the data of the study was collected at 12.2007-2.2008, via a performed questionaire , and face to face performing method.The dependent variables of the study:(WHOQOL-Bref) and WHOQOL general health quality facet; (WHOQOL-Old), and E_AYTA ( European Aging And Attitude Questionaire)Sociodemographical properties, residence properties, habituals, possibilities, social relationships,health conditions and getting ill,( health change according to the previos year), the variables related to attending to the health institutions, the daily life activity variables, were the independent variables of the study.Mann whitney u in non parametric conditions, student?s t test, effect size, ANOVA, Post Hoc Tukey?s b, Kruskall Wallis (nonparametric), chi square test, logistic regretion model , lineer regretion model were used in the analysis. The data were evaluated via 10.0 program for Windows.RESULTSThe olds? mean age was 73.0±6.38(min:65, max:98) ,%67.2 women, %38.2 men,%52 non literatured,%34.4 nonreader and nonwriter. %21 olds didn?t have a social security and%15 didn?t have a health security. %41 olds perceived themselves as poor. %20 of the olds ware living alone,%75 were living in the urban area,%10 of the olds were living in slums of the suburban areas of the study district. The olds? %74 were in close relationship with their children, %53 with their relatives at least once per a week. The %94 of the olds were pleased with their families attitudes to themselves. %6 of the olds were receiving bad attitudes from their relatives.The olds only %12 were walking at least once per a week. %18 of the olds didn?t have a chronical disease,%19 were hospitalised in the past year,%34 olds said that they perceived their helth worse according to previous year and %11 of the olds said that they perceived their health better. Only %34 of the olds could receive continious health service,and %77 of the olds found their home care as sufficient.According to the analysis, there was a lineer relationship between age,living area, the relationship frequency with the family members, being active and independent in life,perceived health, attendence to health services and AYTA psychological negativeAge and independency were not related with psychological positive.Access to health services and health service continuity were related with psychological positive.İn the physical domain men got higher scores than women. While meeting with friends were only related with psychological positive domain, being in correspendance with the relatives was the important variable related with psychological and physical domain scores. Katz index was affected by physical and psychological negative domains.AYTA physical domain skor showed significant associations with socioechonomic, social life and attaining health services? variables.When General health quality facet was taken as a dependent variable, significant relationship was found with all independent variables except age and gender. The ones who didn?t have a chronical disease had higher life quality.The most important variables effecting WHOQOL_Bref physical domain were not being older old,men,literatured,high socioechonomic status,living in the same residence,walking, meeting with children, sufficent home care, attaining to health services, continious health care usage, not having chronical disease, having a good ill health in the past month.Nearly all of the variables were affected psychological domain, however in the multiple analysis socioechonomic status, a good living home conditions, not being ill, attaining to health services affected this domain.Social relations domain was not affected by gender, income,health services while other domains did so.Environment domain showed significant relationship with socioechonomic, daily life activities, attaining to health services,service continuity variables.Except for WHOQOL_Old past present and future activities domain, all of the remaining domains of WHOQOL_Old showed significance with socioechonomic variables.WHOQOL_Old sensory abilities domain was affected by home care variables.WHOQOL_Old autonomy domain was affected by being handicapped, woman gender,living at the rural or preurban sites.WHOQOL-Old sensory abilities,autonomy and past-present-future activities domains were not sensitive to potantial independent variables while the other domains were sensitive.With the social participation domain, living in the rural area,being literatured, living independent housing, using social relationship materials, being with children, attending to health services easily, independency in daily living activities variables showed significance.WHOQOL_Old intimacy domain score, showed significant relationships with all variables except getting ill during the past month, handicapped, health care continuity variables.Health change perception according to past year was sensitive towards health quality and aging attitude domains.Health quality and aging perceptions of olds were sensitive to socioechonomic, sickness and health service variablesBeing in low social status, attending hardly to health services, noncontinuity in the health care usage affects aging attitudes, perceived health and health quality.SUGGESTİONS:The tools that are evaluating perceived health,health quality in the public and institutional level must be used with the other evaluating criterians.The older people who are in the lower social status and the ones living alone in the urban sites are special risk groups. In the social programs these groups must be cared and systematically observed.