PROFESSIONAL TRENDS IN ASIA

Development and Validation of a Body
Image Assessment for Patient after Lower
Limb Amputation—The Chinese Amputee
Body Image Scale-CABIS—Frank Ho-yin LAI1, Eric WONG2, Simon Kam-man WONG1,
Antonia Ka-wai SOO1, Keith Tsz-fai YIP1,
Candy Kiu-chor CHAN1, Phyllis Lai-chu TSE1
1Occupational Therapy Department, Tai Po Hospital, Tai Po
2Centre of Epidemiology and Biostatistics, School of Public Health, The Chinese

University of Hong Kong

Abstract: Rehabilitation professionals increasingly understand that psychological issue
is an important key to achieve rehabilitation goals. Previous studies proved that body
image has significant relationship with amputation rehabilitation, however, measurements
on body image are not well stated. The aim of this study is to develop a Chinese versionof Amputee Body Image Scale (CABIS). In this study, linguistic validity, content
validity, test-retest reliability and construct-validity were examined. The 20 items CABIS
showed with clear presentation and good content understandability. Expert panel agreed
that CABIS covered major constructs in body image for patients after amputation.
Moreover, test-retest reliability was found to be good (α= .857, p< .01). A three-factor
structure can be extracted from factor analysis. These three factors were personal factor,
social factor and functional factor. Furthermore, the internal consistency of the three
individual factors and the overall CABIS were .852, .826, .636, and .694 respectively.
The moderate internal consistency further confirmed that the items within each factor of
the CABIS measure the same construct. Some psychometric properties of CABIS werecollected. Further research on criterion-related validity and improvement on factor
stability are recommended.
Key words: amputation, body image, validation, professional trends(Asian J Occup Ther 4: 1–11, 2005)

Introduction
Received: August 19, 2004, Accepted: April 16, 2005
Corresponding to: Frank Ho-yin, Lai; Occupational
Therapy Department, Tai Po Hospital, Tai Po, Hong Kongphone: 852-2607-6505 fax: 852-2663-1073
e-mail: laihoyinfrank@yahoo.com, laihyf@sinaman.com

Amputation of a limb may be needed to treat
critical ischemia, severe tissue damage due to a
trauma, or a life-threatening condition of a limb.
Although amputation can be beneficial from a
medical point of view, the loss of limb may have a

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THE CHINESE AMPUTEE BODY IMAGE SCALE–CABIS

considerable impact on patients’ health-related
quality of life as shown by Van der Schans et al.
(2002). As shown by the work of Lerner, Esterhai
and Polomano (1993) stated that patients after
amputation were “mentally scarred”, but it wasalso reported that these subjects showed only
limited restrictions in lifestyle and activity. Smith,Horn and Malchow (1995) investigated a group of
unilateral below knee amputees, and found that
health-related quality of life in amputees was
lower than in age-matched controls for thedomains “physical function”, “role limitation due
to physical problems”, and “pain”.
Body Image can be defined as the picture that
one has in his mind about the appearance (e.g. sizeand shape) of his body, and the attitude that heforms towards these characteristics of his body.
There are two components of body image: theperceptual part (how one sees his own body), andthe attitudinal part (how one feels about his
perceived bodily appearance) as studied by
Drench (1994). A negative body image can be in
the form of mild feelings of unattractiveness to
extreme obsession with physical appearance that
impairs normal functioning as discussed by Rosen,
Reiter and Orosan (1995). It is also
understandable that body image involves
perception, feelings, emotions and physicalsensation about one’s own body, which weresummarized by Parker (1975), Price (1990), Van
Deusen (1997), Salter (1988), Miller (1991),
Moore & Malone (1989). Moreover, body image
is not static, but ever changing; and is sensitive tochanges in mood, environment and life experienceas shown by the research works of Schontz (1990),
Breakey (1997), Flannery & Faria (1999),
Watanabe, McCluskie and Hakin (1999), Livneh,
Antonak & Gerhart (1990). An important factor in
the rehabilitation of amputees that is often
overlooked is the individuals’ responses toamputation, including the change in body image of
amputee patients and the extent to which thesechanges influence functional outcomes. Assisting
amputee to be successfully integrated into
community necessitates that body image
disturbances associated with amputation be
addressed in rehabilitation as summarized byprevious research works of Newell (1991),

Schultz, Williamson & Bridges (1991), Breakey(1997), Mitchell (1997), Crum et al. (1993), The
Global Lower Extremity Amputation Study Group(1999), and Whyte & Niven (2001).
Conventionally, amputation rehabilitation
service is mainly physically oriented, as physicalassessment and ADL trainings are key
components of most programs. Though in recent
years, more and more psychological elements areincorporated in the program, i.e. counseling andassessment on psychological readiness of bothpatients and care-givers, however, the ratio is stillcomparatively lower than physical elements. In a
recent study on effectiveness of a body image on
amputation rehabilitation, Hanspal (1998) foundthat assessment on perceived body image is an
essential component for amputation rehabilitation
program planning and evaluation.
A valid body image measuring instrument isessential for amputation rehabilitation services.
The development and validation of a socioculturally appropriate Chinese Amputee Body
Image Scale (CABIS) as shown in Fig. 2 cancontribute to enhancement of the existing service
standard.

Amputee body image scale
The Amputee Body Image Scale (ABIS) as
shown in Fig. 1, is comprised of 20 items. The
ABIS assesses how an amputee perceives and feels
about his or her body experience as research works
by Breakey (1997). Subjects have to indicate
responses to the questions. This scale producesscores that range from 20–100, with high scoresindicating high body image disturbance. Threequestions (question 3, 12 and 16) are reversescored. This type of measurement scale isconsidered most appropriate to assess the kind of
domain-specific concept of self as mentioned byMaurer & Pierce (1998).
Construct validity was studied byinvestigating the correlation of the ABIS withother well-known personality scales in the original
study. The ABIS showed statistically significant
correlation with Index of Self-Esteem (ISE)(r=.56, p<.01); Generalized Contentment Scale(GCS) (r=.64, p<.01); Clinical Anxiety Scale(r=.57, p<.01); Satisfaction with Life Scale

Asian J Occup Ther 4: 1–11, 2005

Lai FH et al.

3

Fig. 2. The Chinese Ampute Body Image Scale (CABIS)(SWLS) (r=–.58, p<.01). The findings supported
the interpretation of ABIS as a kind of instrumentthat measures personal and social related
construct.

Methods
The original English version ABIS wastranslated into Chinese and backwardly translatedby two professional translators respectively.
Then, a group of Chinese-speaking people ofvarious educational levels, ranging from primary
to tertiary were recruited to complete aquestionnaire to assess the linguistic validity of the
CABIS. Respondents were required to rate both
the degree of “clear presentation” and content“understandability” of the CABIS, which were
presented in a 0 to 10 likert scale by the use of aquestionnaire. The mean scores of each question
were calculated, and 8.0 was selected as the cut-off
score of a clear presentation and good content
understandability. Comments from respondents

4

THE CHINESE AMPUTEE BODY IMAGE SCALE–CABIS

Fig. 1. The original Amputee Body Image Scale (ABIS)The questionnaire is designed to measure how you see and feel about your body image. It is not a test so
there are no right or wrong answers. Please answer each item as carefully and as accurately as you can byplacing the appropriate number inside each questions as follows.
1 = None of time, 2 = Rarely, 3 = Some of the time, 4 = Most of the time, 5 = All of the time

were critically reviewed and questions weremodified in syntactical or structural aspects.
Then, a group of bilingual expert panels
whom should have at least 5 years of working
experience in amputation rehabilitation wereinvited to complete a questionnaire, which aimed
at evaluating both face and content validity of the
CABIS. The questionnaire was designed to study
the adequacy, accuracy and ease of understandingof translation, face and content validity of theAsian J Occup Ther 4: 1–11, 2005

Lai FH et al.

CABIS. This questionnaire will be sent together
with a covering letter and both CABIS and ABISfor reference. Panel members were invited tojudge whether they agreed the translation of eachquestion was accurate or not, by choosing “Agree”
or “Disagree”. Qualitative comments formodification of translation were also requested if“Disagree” was rate d for that item. The
percentage of agreement in each question was
calculated, and 85% agree was selected as the cutoff score for accurate translation. Comments fromall panels were critically reviewed and descriptive
statistics such as percentage of experts’ agreementon the accuracy of translation was also analyzed.
Basing on the evaluation by the expert panels,
professional translators then further modified andfinalized the CABIS.
Fo r test-ret est rel iabilit y, a group of
amputated patients would be recruited. Selection
criteria should be below-knee amputated patients
aged from 18 to 65, and average time after
amputation should be within two months, should5have no previous major trauma history, andwithout mental function deficiency. They wereasked to complete the CABIS on the day after
admission and two days after their admission.
Such a short interval can ensure there would be no
significant difference in their perceived body
image. The reliability of the CABIS is determinedby intraclass correlation coefficient (ICC) andanalyzed by the model of one way random.
Through power analysis and effect size estimation,
50 subjects were required. And for further factor
structure estimation, sample size of 50 was
marginally satisfactory in factor analysis byprincipal component analysis for constructvalidation.

Results
Linguistic validity
Twenty Chinese-speaking respondents
completed the linguistic validity questionnaire,
which aimed at determining both the degree ofTable 1. Mean scores of linguistic validity of the 20 items of the CABIS
Item No.

Clear Presentation

Understandability

Relevancy to Concept

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

*7.85
*7.68
*7.58
8.47
8.47
8.02
*6.90
*6.95
8.73
8.42
8.97
*7.30
8.18
9.00
8.75
*7.68
8.32
8.92
*7.17
*7.93

*7.77
*7.58
*7.07
8.53
8.53
8.35
* 6.88
*6.85
8.07
8.88
8.77
*7.32
8.15
8.85
8.22
*7.68
8.13
8.77
*7.90
*7.92

*7.08
8.78
8.90
8.67
8.13
7.83
8.23
*6.96
8.93
8.70
8.42
8.17
8.05
8.92
8.43
8.45
8.07
7.10
*7.72
*7.60

*: Mean value of clear presentation and understandability below the cut-off scoreof 8.00, and items required refinement to enhance questions’ clear presentation andunderstandability.

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THE CHINESE AMPUTEE BODY IMAGE SCALE–CABIS

Table 2. Percentage of agreement by panel expert in the translation of 20 items of
the CABIS
Item No.
1
2
3
4
5
6
*7
8
*9
10
11
*12
13
14
15
*16
*17
18
19
20

Agree (numberof panel member)

Disagree (numberof panel member)% of Agreement

7
6
6
7
6
6
5
6
5
6
7
5
6
7
7
5
5
7
6
6

0
1
1
0
1
1
2
1
2
1
0
2
1
0
0
2
2
0
1
1

100
85.7
85.7
100
85.7
85.7
71.4
85.7
71.4
85.7
100
71.4
85.7
100
100
71.4
71.4
100
85.7
85.7

*: level of agreement in accurate translation below 85% of agreement, and these
items need further modification by professional translator.

clear presentation and content understandability of
the CABIS. A stringent mean score of 8.0 was
selected as the cut-off score of a clear presentationand good content understandability. The results
were summarized in Table 1, 9 questions in the
CABIS (1, 2, 3, 7, 8, 12, 16, 19 and 20) showedwith mean score of clear presentation andunderstandability below the cut-off score, which
required refinement to enhance questions’ clear
presentation and understandability.
After those questions were linguisticallyrefined by the translator, all 7 expert panels (4were male and 3 were female; including 4
occupational therapists, 2 physiotherapists and 1
nurse working in a rehabilitation hospital) agreed
the modification can increase the degree of clarity,
comprehensiveness, and comprehensibility of the
CABIS.

Content validity
Table 2 showed the level of agreement of thepanel members on the translation of items of the
CABIS , with ranged from 71.4% to 100%. As
85% agree was selected as the cut-off score for
accurate translation, 5 questions (question 7, 9, 12,
16 and 17) with only 71.4% agreement in the
CABIS were considered as not accurate enough,and needed to be further modified by professionaltranslator.
For content relevancy, CABIS was evaluatedto see whether the questions were relevant to bodyi m a g e f o r p at i e n t s a f t er a m p u t a t i o n . A ssummarized in Table 3, results showed that panel
members agreed that all items were relevant to thecontent area. The percentage of agreement ranged
from 85.7% to 100%, and the median scores wereranged from 4 to 5 in the items. The 20 items in
the CABIS can be regarded as good items. The
content representativeness of the CABIS wasAsian J Occup Ther 4: 1–11, 2005

Lai FH et al.

7

Table 3. Results of content relevancy of the CABIS
Item

Agree

% of Agreement
NeutralDisagree

Measurement Median*

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

100
100
100
100
85.7
85.7
85.7
85.7
100
85.7
85.7
100
100
100
100
100
100
85.7
100
100

0
0
0
0
14.3
14.3
14.3
14.3
0
14.3
14.3
0
0
0
0
0
0
0
0
0

0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
14.3
0
0

4.5
4.5
4.5
4
4
4.5
4.5
4
4.5
4.5
4
4.5
4.5
5
5
5
4
4
4
4

*: Degree of clear presentation and content understandability of the CABIS.

Table 4. Results of content representativeness of the CABIS

Items 1–20

Agree
100

% of Agreement
Neutral0

Disagree0Median4

100% agreement was achieved in the content representativeness of the CABIS.

examined in terms of the 20 items as a whole to themeasurement of body image for patients after
amputation. The result was summarized in Table
4. The percentage of agreement was 100% andmedian score was 4, which indicated all panel
members agreed that these 20 items cover the
major constructs and could represent a person’s
perception on body image.

Test-retest reliability
In testing for the test-retest reliability, a groupof 50 subjects (40 male and 10 female) wererecruited by convenient sampling. Their age

ranged from 35–75 (with mean age 62.3). All
were below-knee-amputated patients, and the timefrom amputation to first interview ranged from1.32 to 1.48 months (with mean 1.42 months).
They were asked to complete the CABIS on the
day after admission (pre-data) and two days after
their admission (post-data), and these pre-and-post
CABIS data were collected for reliability testing.
Reliability of the CABIS was determined by IntraClass Correlation coefficient (ICC) and analyzed
b y t h e m od e l of o ne w a y ra n do m . A f t e r
statistically operation by SPSS 10.0, the test-retest
reliability coefficient of CABIS was .857.

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THE CHINESE AMPUTEE BODY IMAGE SCALE–CABIS

Table 5. Initial statistics for each factor of CABIS
Items

Communality

Factor

Eigenvalue% of Variance

Cumulative %

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

.580
.384
.404
.541
.500
.500
.289
.393
.555
.561
.392
.624
.515
.636
.485
.712
.652
.309
.647
.477

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20

7.424
2.197
1.330
.989
.949
.829
.714
.673
.621
.562
.552
.452
.422
.386
.360
.328
.306
.252
.217
.175

37.11913.985
9.153
4.255
4.143
4.120
3.569
3.365
2.584
2.808
2.262
2.111
1.929
1.800
1.640
1.531
1.261
1.084
1.023
.151

37.11951.10460.25764.51268.65572.77573.34479.70982.29385.10187.36189.47291.40193.20194.84196.48197.74298.82699.849100.000

3 factor structure was shown to have optimal eigenvalue, % of variance and cumulative %Bartlett’s test of sphericity: 925.18 (p=.000).
Kaiser-Meyer-Olkin Measure of Sampling Adequacy: .735.
Extraction method: Principal component analysis.

Factor analysis and construct validity
Factor structure of CABIS was examined byfactor analysis. The result of the Bartlett’s test of
sphericity was 925.18 (p< .000), and the value ofthe Kaiser-Meyer-Olkin Measure of Sampling
Adequacy was .735. The Bartlett’s test of
spherically can be used to test the hypothesis thatthe correlation matrix is an identity matrix. Thatis, all diagonal terms are 1 and all off-diagonalterms are 0. The current study obtained a value of
925.18 for the test of sphericity. Since the value islarge and the associated significance level of 0.000
is small, it is unlikely that the population
correlation matrix is an identity. If the hypothesisthat the population correlation matrix is an identity
c an n o t b e r e j e c t e d b e c a u s e t h e o b se r v e dsignificance level is large, one should reconsider
the use of the factor model (Norussis (1985)). The
good Kaiser-Meyer-Olkin value obtained and thehighly significant level of the test of sphericity,were both very comfortable indications that thegiven set of data were adequate for factor analysis.
T he s e g o od v a l u e s s u pp o rt e d fu r t he r
application of factor analysis to explore the latent
structure of the CABIS. Principal component
analysis method of factor extraction was used inthis study. Table 5 reported the statistics ofprincipal component analysis. In the initial
analysis, a total of three factors could be extractedwith the eigenvalue greater than 1.00. In terms of
total variance, the three factors accounted for60.26% of total variance, which can be considered
as a reasonable factor number. Furthermore, thescree plot in Fig. 3 showed that the curvestraightened out at the three factors. Therefore, thefitness of three-factor solution could be identified.
In the rotation phase of factor analysis, it
aimed at achieving simpler and theoretically moremeaningful factor solutions. Oblimin rotation was
employed in further investigating the factor

Asian J Occup Ther 4: 1–11, 2005

Lai FH et al.

9

Table 6. Factor loadings of items of the CABIS after
oblimin rotation

Fig. 3. Scree plot of the factors of the CABIS
The graph for the scree test is presented in Fig. 3. The scree
diagram of the factors of the CABIS justifies the three-factor
solution to the data. 3-factor structure was shown to have
optimal eigenvalue as shown in this scree plot.

loadings. The result was summarized in Table 6.
The three factors were labeled according to theitems’ nature of construct. Factor 1 was personal
factor; factor 2 was social factor; and factor 3 wasfunctional factor. The value of factor loadings was
the criteria to group the items in different factors
respectively. Personal domain included 9
questions, i.e. question 3,5,6,7,12,16,17,18 and 20(e.g. question 3: I like my overall physicalappearance when wearing my prosthesis). Social
domain included 7 questions, i.e. question
1,2,8,10,11,14 and 15 (e.g. question 1: Because I
am an amputee, I feel more anxious about my
physical appearance in social situation than when I
am alone). Functional domain included 4
questions, i.e. question 4,9,13 and 19 (e.g.
question 4: It concerns my that the loss of my limb
impairs my body’s functional capabilities invarious activities of daily living).
The relationships of these three factors were
examined in terms of item description, internalconsistency and correlation. Cronbach’s alphawas used to measure the internal consistency of the
CABIS. In these three factors, the ranges of itemtotal correlation were .556 to .786, .348 to .653,
and .482 to .658 respectively. They indicated afair relationship of the questions to their respective

Items

Factor 1

5

.908

6

.828

3

.815

12

.697

20

.642

7

.628

17

.586

18

.579

16

.500

Factor 2

14

.836

8

.779

2

.751

1

.701

10

.610

11

.541

15

.505

Factor 3

.467

.358

4

.625

9

.619

19

.599

13

.395

Note. Extraction method: Principal component analysis.
Rotation method: oblimin rotation.
Remark: Only showed factor loadings above .35

factors. The internal consistency of the three
individual factors and the overall CABIS were
found to be .852, .826, .636, and .694 respectively
as shown in Table 7. The moderate internalconsistency implied that the questions within eachfactor and the factors of the CABIS measured thesame construct. Pearson correlation coefficientsamong the three factors were presented. As shownin Table 8, all factors were found to have goodcorrelation with one another (ranged from r=. 532,
p< .000 to r=.652, p<.000). The factor 1 “Personal
factor” and factor 2 “Social Domain” had thehighest relationship (r= .652, p< .000). The

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THE CHINESE AMPUTEE BODY IMAGE SCALE–CABIS

Table 7. Internal consistency of factors in CABIS

Table 9. Reliability coefficient of factors in CABIS

Cronbach’s Alpha of CABIS
Alpha
if deleted
Factor 1–Personal Factor
Factor 2–Social Factor
Factor 3–Functional Factor

.852
.826
.636

Overall CABIS

.694

.432
.597
.623

Table 8. Correlations among factors in CABIS

Personal Factor
Social Factor
Functional Factor

Personal
FactorSocialFactorFunctional
Factor—r=.652
p<.01

r=.532
p=<.01—

r=.545p<.01—

reliability coefficients of ICC among three factors
were .914, .900 and .800 as shown in Table 9,which was good and adequate evidence tosubstantiate the use of CABIS across different
time.

Discussion
In this study, a number of modifications weremade to questions in CABIS. The reasons for thenecessity in modification of questions could bebroadly classified into 5 categories: 1) use of
specific terms in body image measures; 2) use ofgeneric terms was difficult in psychosocial
measurement of Chinese patients; 3) inaccuratetranslation from English to Chinese version; 4)sensation structure difference between ABIS andCABIS; 5) clarification of meaning in
psychosocial construct and 6) grammatical reason
in understanding.
When validating the ABIS to CABIS, factor
structure between “Personal” and “Social” factorsof CABIS might be different from the original
study. It was possibly due to cultural difference
between Western and Chinese, which created adifferent point of view on perceived body image.

Reliability Coefficient
Factor 1–Personal Factor
Factor 2–Social Factor
Factor 3–Functional Factor

.914
.900
.800

Overall CABIS.857

For example, the importance of social importancewould be much more important than personal
acceptance, potential overall estimation on thed i f f i c u l t y i n s o c i a l a c ce p t a n c e , p e r s o n a lcharacteristics such as acceptance in newly
acquired body image and believe in fate andnatural arrangements are often the Chinesepatients’ concern rather than outcomes.
Moreover, Chinese patients showed more concern
over the “functional” aspect rather than “personal”
importance after amputation was also a major
factor for further consideration.
Further validation work was recommended toincorporate more “functional” related questions, tocorrelate if functional improvement could
substantially improve body image and to crossvalidate with other psychosocial instrument or
quality of life measures for patients after
amputation.

Conclusion
The CABIS was developed to assess aperson’s perceived body image. The content
relevancy and representativeness had been
investigated with a high level of agreement. The
test-retest reliability was estimated to be good interms of ICC. The construct validity was analyzed
by factor analysis. A three-factor structure was
extracted. The factor loading of items was ranged
from .395 to .908. The names of three factors werepersonal factor, social factor and functional factor.
A moderate internal consistency was foundbetween items, and the correlations between
factors were considerably to be good. A
confirmatory factor analysis across different
subject groups was recommended in further study
to increase the clinical utilities of CABIS.

Asian J Occup Ther 4: 1–11, 2005

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ORIGINAL ARTICLE

Analysis of the Factors Affecting the
Quality of Life of Elderly in the “Senior
Citizen Academies”
Won-Mee JEONG, PhD, OT1, Tae-Yong SOHN, PhD2
1Department of Occupational Therapy, Dongnam Health College,
2Department of Health Services Administration, Yuhan College

Abstract: The purpose of this study is to improve the elderly’ quality of life examining
the factors which influence their quality of life and related different components.
The main results of this research are as follows;
1. The relationship between the demographic characteristics and quality of life wasanalyzed, respondents who had higher educational background or standard of living
showed higher level of quality of life.
2. The relationship between the health perception characteristics and quality of life wasanalyzed, the respondents who responded as “I am healthy.” or “I am healthier than same
aged people.” showed higher level of quality of life.
3. The relationship between the physical and functional condition of the elderly and qualityof life was analyzed. The results showed that male respondents had higher quality of life
than female, and had higher educational background showed higher level of quality of life.
4. The relationship between the 6 factors’ viewpoint according to health perception
characteristics and quality of life was analyzed, the respondents who responded as “I amhealthy.” or “I am healthier than same aged people.” showed higher level of quality of life.
The results of this study showed that the influential factor affecting the elderly’ qualityof life was the health perception factor. Therefore, it is required that the program ofsenior citizen academy should include systematic health promotion education reflecting
the elderly’ demand.
Key words:

elderly, quality of life, the senior citizen academies(Asian J Occup Ther 4: 13–23, 2005)

Introduction

Received: August 10, 2004, Accepted November 21, 2004
Corresponding to: Won-Mee Jeong (PhD, OT);
Department of Occupational Therapy, Dongnam HealthCollege, 937 Jungja-Dong, Jangan-Gu, Suwon, GyeonggiDo, Korea 440-714
Phone: 82-31-2496-583 fax: 82-31-2496-580
e-male: time@dongnam.ac.kr

Korea entered the aging society in 2000 as its
elderly population accounted for 7.2% of total
population. In 2019, it is expected to be the aged
society with over 14% of the elderly population.
In 2026, it will be the hyper-aged society.
Agricultural and fishery areas already entered theaged society in 2002, with 15.8% of 65 yrs andover population. (Korea National Statistics Office14

QUALITY OF LIFE OF ELDERLY(KNSO), 2003). The aging of population in Korea
is much faster than in developed countries such as
the United States, Japan and the United Kingdom(Ministry Health & Welfare (MHW), 2000).
Questions are raised on who will pay forliving expenses, medical and nursing care bills of
the elderly and how various services are provided
for them. The aging population and thesubsequent longer senescence period pose large
challenge to not only the elderly but also the nation(Ko & Joe, 1997; Koh, 2000). Furthermore,decreased labor productivity resulting from theaging society gives rise to slowdown in economic
growth and growing burden of supporting oldpeople. Accordingly conflicts between
generations get fiercer. Increasing expenditure forthe elderly such as medical expenses causes thegovernment’s financial balance to deteriorate. The
government perceives a wide range ofrepercussions arising from the aging population as
important challenge largely affecting families andthe society as a whole. Therefore, it executes
health and welfare polices, and the related
institutions for the elderly. However, compared todeveloped countries, Korea lacks the developmentof elderly health and welfare systems (MHW,
2003; Ministry of Labor (MOL), 2004).
Moreover, much more preparation foroccupational therapy is required to respondproperly to the policy direction with respect tohealthcare, and welfare services (Jeong & Choi,
2003).
The quality of life deals with level of living
conditions, and value of human life. It iscomprehensive and multi-dimensional concept
since different researchers approach the quality oflife with different views, goals and methods.
Johnson et al. (1982) defined it as subjective
satisfaction an individual expresses or experienceswith respect to physical, social and economic
conditions. Homes and Dickerson (1987) said thatthe quality of life is an abstract and composite term
indicating individual’s reactions to mental,
physical and social factors in normal daily life.
Old people in Korea usually show low life
satisfaction. The big issue of the elderly after
retirement is financial problems in case of thelower class. On the other hand, those in the middle

and upper class face the issue of how they canspend spare time. It is reported that the range ofleisure activities is limited for the elderly and their
participation is also very low (Kim et al., 1998;
1999).
Many scholars conduct researches
ceaselessly to identify factors affecting the qualityof life. The focus of these studies is on identifying
what constitutes life and what affects life (Ro etal., 1999). Analysis of previous researches
suggests that factors influencing the quality of life
include gender, age, education, occupation,
incom e, an d marital stat us, and relig ion,
participation in the society, race, and health (Ko &Joe, 1997). As welfare services for the elderly,
income guarantee, housing service, services fromwelfare facilities, health and medical services, andeducation and leisure services can be solutions toelderly problems, which ultimately improve thequality of life (Nam, 1992). Major elderly welfare
facilities offering educational and leisure activities
are educational organizations for the elderly, socalled “senior citizen academies” and elderly
educational programs, so-called “Elderly Class”.
These organization and program provide lifelong
learning programs related to hobby, healthmaintenance, income security, and other daily liferelated activities (Jeong, 1998). It is known thatold people in poor social and economic conditions
are highly susceptible to dementia and depression.
It implies that programs and services for thosepeople should be developed and provided before
anything else. Measures to improve the access ofthe elderly to medical treatment and services need
to be sought (Jeong et al., 2002).
Services including occupational therapy forold people are closely associated with not only
individual treatment but also the government’s
policies since elderly population affects the overallsociety. Therefore, it is essential to set a direction
for development of occupational therapy for theelderly in line with the government’s policy
direction.
This study is to examine old people in the“senior citizen academies”, the place for life-long
education to identify health perception features,closely related to the quality of their life, in linewith the health and welfare policy direction for theAsian J Occup Ther 4: 13–23, 2005

aging society. This study is intended to provide
primary data for efficient preparation foroccupational therapy aiming at increasing
satisfaction and usage level with respect toplanning and execution of programs. The
planning and execution of the programs take into
account approaches to improvement of the qualityof life of the elderly in communities, and related
factors.

Methodology
Subject & data collection method
The survey for this study was conducted on
200 old people in two “senior citizen academies”
located in Gyeonggi-Do, Korea. These two seniorcitizen academies were selected because they wererunning educational programs in a systemic way.
200 surveys were chosen by random sampling. 19
of 200 respondents were not included for the survey
analysis since their responses were insufficient, or
h a d l a c k e d i n f o r m a t i on . E v e n t u a l l y 1 8 1
respondents were involved in the survey.
As far as data collection method is concerned,
the researcher and two or three teachers obtained
prior training for data collection worked as aninterviewer using structured questionnaires. Manto-man interview and self-filling-up ofquestionnaire were used. Data was collected from
September 1 to October 30, 2003.
A measurement tool used for this study isquestionnaire, which was developed by Ro (1988)
for middle-aged adults in Seoul whose reliability
was verified by Chae & Oh (1992) to use it for theelderly.

Variables definition
A dependent variable used for this study is
the level of the quality of life. Independent
variables are demographic characteristics,
characteristics of “senior citizen academies”, andhealth perception characteristics.
Elements constituting the quality of life weredealt with in 39 questions. Factor analysis was
conducted for these questions. The components
were divided into 6 categories including healthstatus, functions, psychological status, selfesteem, relationships with family and neighbors,

Jeong WM et al.

15

economic life, and periphery and leisure life.
Health status and functions were assessed by
7 questions (extent of activities, activity status,
body status, urination and bowel movement, sleep,
physical fatigue and discomfort). Psychologicalconditions were asked with 8 questions (anxiety, afeeling of depressed, fear, concerns, anger, mental
hunger, a sense of failure, calmness). Self-esteem
was m easured by 8 questi ons (a sense of
worthiness, life motivation, undertaking manytasks, clear goals, self-respect, adaptation toenvironmental changes, an ability to work,
optimistic life). Relationships with family andneighbors were assessed by 6 questions(relationship with children, relationship withsiblings and relatives, position in the family,
relationship with neighbors, relationship withfriends, mutual trust and support). Economic
conditions were measured by 7 questions (monthly
income, assets, preparation for post-retirement
period, clothing, overall life, food, current job).
Surrounding conditions and leisure activities wereasked by 3 questions (home and periphery
activities, leisure activities, appearance).
Scoring scale ranges from point 1 (very poor)
indicating to point 5 (very good). Scores werecombined for totalizations. The scope of score is
between 7 and 35 for health status and functions,
between 8 and 40 for psychological conditions,
between 8 and 40 for self-esteem, between 6 and30 for relationships with family and neighbors,
between 7 and 35 for economic life, and between 3
and 15 for periphery conditions and leisureactivities. The higher score is the higher quality oflife is. Total scores range from 39 to 195. The
higher scores are the higher quality of life is. The
reliability level of the tool used was 0.89.

Framework and analysis method
Data analysis was carried out according to the
purposes of this study as follows; first, t-test anddistribution analysis were conducted to find out
whether or not characteristics affect the quality oflife of the surveys. Second, factor analysis oncomponents of the quality of life was conducted toassess various factors related to the quality of life
in a similar way. Moreover, t-test and distribution
analysis were carried out to compare factors

16

QUALITY OF LIFE OF ELDERLY

extracted from the factor analysis withdemographic characteristics, and health perception
characteristics. Third, multiple regression analysis
was conducted to figure out what is the importantfactors affecting the quality of life using
demographic characteristics and health perception
characteristics as independent variables.

than those who did not, those living withunmarried children rather than those who were
not. Among health perception characteristics,
those who are healthy or healthier than the sameage group show higher quality of life than those
who are not healthy. Factors selected for thismodel are 29.8% convincing.

Results

Comparison of the quality of life components
to demographic characteristics

The quality of life by demographic
characteristics
It was found that the quality of life was highif the survives are high-school graduates, well off,or live together with children who are single. The
different degree of the quality of life wasstatistically significant (Table 1).

The quality of life by health perception
characteristics
Statistical significance was found in the
degree of the quality of life if the respondents said,
they were healthy, healthier than the same agegroup or diagnosed with diabetes (Table 2).

Regression analysis on factors affecting thequality of life
Multiple regression analysis was conducted
on all variables to assess factors influencing thequality of life. After removing multicollinearity,
correlation analysis was undertaken to remove
variables whose correlation coefficient with subva ri ab l es i s l o w, a m on g va ri ab l es w ho secorrelation coefficient between independent
variables is 0.7 or more. Through these processes,
demographic characteristics including age, living
standards, allowance, heath status, and presence orabsence of a disease were used as independent
variables for the regression analysis.
The results of multiple regression analysis aredescribed in Table 3. Such independent variables
as gender, educational level, living standards, andpresence or absence of a disease were processed asdummy variable for the analysis.
As for demographic characteristics, higher
quality of life was identified in those with highschool degree or higher rather than those who are
not, those who replied they were well off rather

As a result of factor analysis, factors affecting
the quality of life were divided into 6 different
categories including body condition and functions,
psychological status, self-esteem, relationships
with family and neighbors, economic conditions,periphery conditions and leisure activities.
T h e qu a l it y of l i f e c o m p o n e n t s w e r ecategorized into 6 groups and compared withdemographic characteristics. The findings are
depicted in Table 4.
The quality of life with respect to body status
and functions was higher in male than in female
and it was also better in those with college degree
or higher than those with high school degree or
lower. In terms of psychological status, the qualityof life was higher in male than in female. If those
who have high school degree or are living withunmarried children or others, the quality of life
was higher.
As for self-esteem, those who replied they
were well off or who responded children supported
their living expenses seemed to have the higher
quality of life.

Comparison with the quality of life components
to health perception characteristics
The quality of life components were divided
into 6 categories and compared to healthperception characteristics as seen in Table 5.
As for the quality of life related to body
conditions and functions, statistical differenceswere in those who do not suffer from diseases, arehealthy or healthier than the age group compared.
Their quality of life was higher than otherwise. In
terms of psychological conditions, the quality oflife was higher in those who are healthy or
healthier than the age group compared. The
differences were statistically significant.

Asian J Occup Ther 4: 13–23, 2005

Jeong WM et al.

Table 1. Comparison of the subjects by Quality of life and demographical characteristics

Unit: Mean ± SD

Category

Quality of lifet value or F value

GenderMale
Female137.93 ± 23.00
126.55 ± 16.48

1.874

Age

Under 66
67–72
Over 73

125.28 ± 19.32
128.44 ± 15.81
128.37 ± 17.21

0.607

Religion

Christianity
Buddhism
Roman Catholicism
None

120.00 ± 15.70
129.76 ± 14.43
128.01 ± 17.66
122.24 ± 18.45

0.947

Education

None
Elementary school
Middle school
High school
college or higher education than college

126.19 ± 13.70
127.17 ± 14.77
120.35 ± 17.41
137.33 ± 22.70
135.67 ± 22.09

4.212**

Marital status

MarriedParted by death

125.90 ± 18.29
129.46 ± 15.94–1.377

Living standard

Poor
Average
Wealthy117.17 ± 12.05
127.30 ± 16.88
146.88 ± 19.00

7.679*How to earn living expenses

By working
On retirement funds
On savings
On children’s support
On pension and living grants
Others118.67 ± 19.63
127.83 ± 21.54
133.23 ± 18.60
128.01 ± 16.92
126.14 ± 11.49
112.00 ± 9.01

1.271

Allowances (monthly)

Less than 100,000 won
110,000–200,000 wonMore than 210,000

124.85 ± 15.93
129.64 ± 16.91
130.04 ± 19.75

1.892

People living together

Son’s family
Daughter’s family
Unmarried children
Old spouse
Alone
Others127.67 ± 15.08
130.00 ± 16.31
140.59 ± 21.43
123.71 ± 18.65
124.48 ± 11.73
129.12 ± 19.03

3.701**The biggest problems

Health problems
Economic problems
Separation with the spouse
Solitude and loneliness
Bad terms with children
Nothing to do

127.50 ± 17.18
128.75 ± 20.23
126.12 ± 16.63
122.00 ± 16.21
157.67 ± 26.55
125.87 ± 17.34

2.256* p< .05, ** p< .01

17

18

QUALITY OF LIFE OF ELDERLY

Table 2. Comparison of the subjects by Quality of life and health perception characteristics
Category

Unit: Mean ± SD

Quality of lifet value or F value

DiseaseAbsence
Presence132.70 ± 20.97
126.46 ± 16.39

1.814

Diagnosis

Hypertension
Diabetes
Arthritis
Heart disease
Others124.20 ± 17.81
137.25 ± 17.01
128.79 ± 13.97
113.58 ± 12.10
135.28 ± 21.72

4.850**

Health status

Poor
Average
Healthy119.05 ± 15.37
125.40 ± 15.87
145.38 ± 14.27

23.956***Same age group
Healthy status

Poor
Average
Healthy120.86 ± 16.70
123.73 ± 15.01
140.81 ± 16.49

19.533*****p < .01, ***p < .001

Table 3. Regression analysis on factors affecting the quality of life
Variable

Regression coefficient (β)

Demographic characteristic
AgeAllowance (monthly)
Gender (female=1, male=0)
Education (over high school=1,
under middle school=0)
Living Standard (wealthy=1, poor=0)
Living together(unmarried children=1, others=0)
Health perception characteristics
Health status (healthy=1, poor=0)
Same group aged (Healthy=1, poor=0)
Disease (presence=1, absence=0)
Constant

Standard Error

P-value

0.33690.0151
3.46600.20380.08204.90000.09960.8532
0.48128.435314.1284

3.39805.42000.01420.0102

13.83443.87200.000311.45648.34282.209191.4764.6626
3.99443.141016.4061

0.01580.03800.48300.0000Adj R2=0.298
F value=9.498 (P= .000)

With respect to self-esteem, the quality of life
was higher in those who are healthy or healthierthan the age group than in those who areotherwise. Those who are healthy showed thehigher quality of life in relation to relationships
with family and neighbors.
For economic life is concerned, the quality oflife was better in those who are healthy or healthierthan the age group than in those who areotherwise. In terms of periphery and leisureactivities, the quality of life was also better inthose who are healthy or healthier than thecompared age group than in those who areotherwise.

Discussion
As for demographic characteristics, theAsian J Occup Ther 4: 13–23, 2005

Jeong WM et al.

Table 4. Comparison of the subjects by Quality of life components and demographical characteristics
Category

Factors 1

Factors 2

Factors 3

Factors 4
t/F

Unit: Mean

Factors 5
t/F

19

Factors 6

t/F

t/F

t/F

2.556*

t/F

28.27
27.22

0.678

18.80
19.17

0.386

24.80
23.78

0.745 10.47
9.75

1.075

Male
Female

25.20
20.52

4.300***30.40

Age

Under 66
67–72
Over 73

21.64
21.04
20.12

1.906

26.53
26.63
26.18

0.084

26.89
27.16
27.85

0.436

18.53
19.62
19.13

1.418

22.47
24.24
24.68

3.045*

9.23
9.75
10.40

3.313*

Religion

Christianity
Buddhism
Roman Catholicism
None

18.33
21.00
21.15
21.00

1.483

25.11
25.57
26.75
25.41

0.433

26.22
28.29
27.30
26.54

0.390

18.78
19.38
19.22
18.15

0.418

22.44
25.14
23.80
23.54

0.706

9.01
10.38
9.78
9.56

0.630

Education

None
Elementary school
Middle school
High school
Higher education
than college

21.48
20.34
19.03
23.46
24.56

6.857** 25.45
25.73
24.65
31.50
29.89

6.242** 26.19
27.58
25.91
28.83
29.89

1.755

19.29
19.13
18.62
20.04
18.22

0.736

23.45
24.37
22.88
24.21
23.44

0.620 10.32
10.01
9.26
9.29
9.67

1.170

Marital status

MarriedParted by death

20.68 –0.819
21.20

25.93
27.10

–1.233

27.06
27.62

0.653

18.89
19.44

1.049

23.79
23.96

0.228

9.55
10.14

1.598

Livingstandard

Poor
Average
Wealthy

20.50
20.81
23.63

1.771

24.75
26.55
27.13

0.491

25.42
27.17
33.00

4.905** 17.75
19.16
20.75

1.771

19.42
23.87
30.50

13.063** 9.33
9.75
11.88

3.167*How to earn
By working
living Expenses On retirement funds
On savings
On children’s support
On pension andliving Grants
Others

21.25
20.33
21.72
20.41

0.785

25.83
31.00
26.97
26.20

1.779

24.08
25.67
28.03
28.17

2.342*

0.638

21.83
22.92
25.41
23.37

1.940

2.178

Allowances(monthly)Less than 100,000 won
110,000–200,000 wonMore than 210,000

20.29
21.82
21.07

2.120

26.31
26.98
26.15

0.244

26.87
27.14
28.30

0.975

18.82
19.48
19.35

0.648

23.13
24.24
24.83

1.884

9.42
9.98
10.35

2.295

People living
together

Son’s family
Daughter’s family
Unmarried children
Old spouse
Alone
Others

20.80
23.00
22.65
20.35
20.36
22.50

1.440

25.34
26.70
31.00
26.40
25.88
32.50

2.677*

28.19
25.70
29.12
26.32
26.16
34.50

2.091

19.28
19.90
21.00
18.20
19.32
20.50

2.029

23.87
24.40
27.29
23.13
22.68
29.00

2.637* 10.09
10.30
9.54
9.32
10.08
12.00

1.159

The biggest
problems

Health problems
Economic problems
Separation with the
spouseSolitude and loneliness
Bad terms with children
Nothing to do

20.40
22.65

1.948

26.25
26.40

1.170

27.46
27.40

1.417

19.19
20.35

1.054

24.37
22.35

2.131

1.817

Gender

26.10

21.71
22.00

21.43
21.60
25.67
20.87

24.57
24.21

27.57
24.87
33.67
27.80

*p< .05, **p< .01, ***p< .001

†Factor 1: factors related to physical conditions and functions,
Factor 2: factors related to mental status,
Factor 3: factors related to self-respect,
Factor 4: factors related to the relations with family/neighbors,
Factor 5: factors related to economic life,
Factor 6: factors related to activities around and leisure activities.

25.24
23.42

26.14
27.20
34.33
25.20

18.58
18.58
19.56
18.97
19.95
18.00

18.43
18.13
20.33
18.20

25.29
21.50

23.00
21.27
30.33
23.53

8.08
9.33
10.54
9.89
9.38
9.48

9.83
9.60
9.43
8.93
13.22
10.27

20

QUALITY OF LIFE OF ELDERLY

Table 5. Comparison of the subjects by Quality of life components and health perception characteristics
Category

Factors 1

t/F

Factors 2

t/F

Factors 3

t/F

Factors 4

t/F

Factors 5 t/F

Unit: Mean
Factors 6 t/F

DiseaseAbsence
Presence

22.70
20.56

2.578*

28.57
26.03

2.012*

27.53
27.26

0.235

19.13
19.14

–0.008

24.40
23.76

0.630

10.37 1.353
9.70

Diagnosis

Hypertension
Diabetes
Arthritis
Heart disease
Others

20.75
21.83
20.44
16.67
22.93

5.714** 26.62
30.00
26.02
25.00
27.07

0.891

26.09
27.38
27.90
24.75
29.93

3.136*

18.67
21.63
19.53
17.17
19.76

2.597* 22.49
25.50
24.89
21.33
25.52

3.529**

9.58 0.940
9.88
10.02
8.67
10.07

Health status Poor
Average
Healthy

18.70
21.13
24.79

26.393*** 25.63
26.18
29.00

2.977*

26.73 11.933*** 19.00
26.28
18.64
31.76
21.00

5.199* 22.78
23.48
27.34

9.283**

9.20 9.463**
9.68
11.48

Same agegroup healthstatus

18.79
20.46
24.07

21.651*** 26.69
25.40
28.64

3.980*

26.81
26.18
30.43

9.132*** 18.33
18.96
20.36

3.820* 22.95
23.23
26.26

6.550*

9.29 7.505*
9.51
11.05

Poor
Average
Healthy*p< .05, **p< .01, ***p< .001

†Factor 1: factors related to physical conditions and functions,
Factor 2: factors related to mental status,
Factor 3: factors related to self-respect,
Factor 4: factors related to the relations with family/neighbors,
Factor 5: factors related to economic life,
Factor 6: factors related to activities around and leisure activities.

higher education level is and the higher living
standards are, the higher quality of life was. Suchfinding was matched with the findings fromstudies of Kim et al. (1999), Park (1998) and Kim(2003) that the quality of life for the elderly
seemed better as their education level is higher ortheir living standards are higher.
The quality of life was higher in those whoare between 67 and 72, have religion, or whose
spouse was dead than those who are otherwise.
These differences were insignificant. In theprevious study, Park (1998) suggested that thosewith religion showed higher satisfaction with theirlife than those without religion. The study of Ko& Joe (1997) unveiled that religion was a powerfulvariable in improving the quality of life.
Among the old people under the focus of thisstudy, those who replied they were healthy andhealthier than the compared age group had thehigh quality of life, which was statisticallysignificant, regarding health perception
characteristics. This finding is line with the resultsof researches by Byun (1998), Park (1998), Kim etal. (1998). As the previous studies suggested that

health is a very crucial factor influencing thequality of life of the elderly, improvement ofhealth play a very important role in enhancing thequality of life of the elderly. With the objective ofensuring stable, healthy and lively life of theelderly, the health and welfare policies in 2004 in
response to the aging society pursue theintroduction of public nursing care insurance forthe old people, and expansion of infrastructuresuch as nursing facilities and human resources. In
this regard, more occupational therapists should be
nurtured to secure professionals to help the elderly
to maintain their health in order to improve healthand the quality of life of the elderly. Furthermore,
we need to consider the adoption of occupational
therapy in development of the elderly healthprograms. Life-long education should be provided
systematically to create sound leisure culture.
Studies on needs for mental health services
for the elderly point out those residents incommunities perceive dementia as a mental healthproblem of the elderly and therefore, projects forthe related health service need to be reinforced(Jeong, 2001). Programs should be developed andAsian J Occup Ther 4: 13–23, 2005

applied to the reality with consideration of theelderly heath conditions and the needs for theelderly health and welfare service.
This study takes a look at components of thequality of life by demographic characteristics andhealth perception characteristics. The quality oflife with respect to body conditions and functions
was higher in male than in female. It was also
better in those with college degree or higher thanthose with high school degree or lower. The gap in
the quality of life was statistically significant. In
terms of psychological status, the quality of life
was higher in male than in female. When oldpeople have high school degree or are living withunmarried children or others, the quality of life
was higher.
Such results showed that male, higheducational level, living together with unmarried
children, and high living standards aredemographic characteristics having positive
impacts on components of the quality of life. Rhee
(1999) suggested in comparison of the quality oflife by demographic characteristics that serious
and obvious differences between populationgroups in different aspects of life are shown
between men and women. The gap between old
men and old women is created not simply insenescence period but it has been accumulatedsocially through the periods of the whole life.
Therefore, such gap occurs more obviously insenescence period.
The high quality of life of the elderly who areliving with single children or others suggests thatold people may be proud of themselves as
supporter of children by providing financial
assistance to their children who are grown-ups. It
also implies that the largest satisfaction with life to
the elderly stems from love that they feel whileliving together with their children and grandchildren. Kim et al. (1999) proved that familycohesion is an important variable in a sense of
subjective well-being. Given all, family members
need to strive to sustain good family relationshipto help the elderly enjoy the high quality of life.
As for the quality of life related to body
conditions and functions, statistical differenceswere in those who do not suffer from diseases, arehealthy or healthier than the age group compared.

Jeong WM et al.

21

Their quality of life is higher.
These findings show that the perception thatthe elderly themselves are healthy or healthier thanothers in the age group compared is a variableinfluencing 6 components of the quality of life.
Health perception characteristics are the mostpowerful factor in the quality of life of the elderly.

Limitation and Suggestion
This study was aimed to analyze variables
affecting the quality of life for the elderly byassessing the quality of their life. However, thisstudy has limitations with respect to methodology;First, the tool used for this study was developed by
Ro (1988) for middle-aged people in Seoul. Chae
& Oh verified its reliability for the elderly (1992).
Therefore, it should be prudent to expand andinterpret the findings. Second, old people under
the focus of this study were selected by random
sampling among those from the senior citizen
academies, living in Gyeonggi-Do, Korea. Hence,
it is difficult to see them representing the entire
elderly population in Korea.
In line with priorities and action plan withrespect to the government’s health and welfare
policies in response to the aging society; first, thisstudy finds that health perception characteristics
are the most powerful factor influencing thequality of life of old people in senior citizen
academies. Therefore, professional staffs for theelderly health and welfare services need to develop
health-related educational programs to help old
people maintain and improve physical andpsychological health to ensure that the quality oflife for the elderly is enhanced. Second, since
factors affecting the quality of life differ between
old people in senior citizen academies and oldpeople in communities, further study should beundertaken on the elderly in communities tocompare those factors between the two groups.
Third, we can hardly find measurement tools
recently developed regarding the quality of life of
the elderly. Accordingly, development of
measurement tool is required for the quality of lifeof the elderly.
In order to deal with problems arising fromthe aging population efficiently, the elderly healthand welfare facilities, and the related human

22

QUALITY OF LIFE OF ELDERLY

resources need to be prepared to have balance indemand and supply so that more opportunities
should be provided for healthy old people toparticipate in the society. Therefore, the role ofoccupational therapists needs to be expanded fornational development and improvement in thequality of life. There is the hope that occupational
therapy for the elderly will drive such socialchanges.

Conclusion
This study aimed at providing primary datafor improvement of the quality of life for theelderly by assessing the quality of life of oldpeople in the senior citizen academies. 181 oldpeople in the senior citizen academies were under
the focus of this study to identify what constitutes
the quality of life, and figure out differences
between those components. Unit for the analysisof this study was individuals. An interview on theelderly in the senior citizen academies was used
for data collection.
The findings of this study are as follows:First, in terms of demographic characteristics,
the elderly with high educational level and highliving standards had the high quality of life, whichis statistically significant.
Second, as for health perception
characteristics, statistically significant differenceswere found in the degree of the quality of life if theelderly are healthy or healthier than the compared
age group.
Third, among demographic characteristics,
the quality of life with respect to body status andfunctions was higher in male than in female and it
was also better in those with college degree orhigher than those with high school degree or
lower. The gap in the quality of life wasstatistically significant. In terms of psychologicalstatus, the quality of life was higher in male than infemale. If those who have high school degree orare living with unmarried children or others, thequality of life was better. When it comes toeconomic conditions, the quality of life was higher
in those who are well off, or live together withothers.
Fourth, the quality of life in relation to its 6

components by health perception characteristics
was higher in those who replied they were healthyor healthier than the age group compared thanthose who replied otherwise. The differences were
statistically significant.
This study concludes that education level andliving standards are important demographic
characteristics affecting the quality of life of oldpeople in the senior citizen academies, and theperception of being healthy or healthier than othersin the compared age group is important healthperception characteristics. Ultimately, healthperception characteristics are the most powerfulfactor influencing the quality of life of the elderly
studied.
Accordingly, this study strived to identify
important factors affecting the quality of life of oldpeople in the senior citizen academies, and analyze
characteristics of the old people under the focus of
this study, quality of life components, and related
variables. It is significant that by dong so, thisstudy was intended to provide primary data fordevelopment and application of community healthimprovement programs to enhance the quality oflife of the elderly.

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