Factors Influencing Health Status in Community-Dwelling Older Adults

FACTORS INFLUENCING HEALTH STATUS IN COMMUNITY-DWELLING OLDER ADULTS By Janet Jestina Byam-Williams, RN, MSN, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University Virginia Commonwealth University, 2006 Major Director: Jeanne Salyer, RN, Ph.D. Associate Professor, School of Nursing This descriptive, correlational study was based on Pender's Health Promotion Model (Pender, Murdaugh, & Parsons, 2002). The purpose was to examine factors influencing health status in community-dwelling, older white and black adults. The following research question was addressed by the study: What are the relationships among the individual characteristics (age, gender, race, education, and income); the behavior-specific cognitions and affect (perceived self-efficacy, perceived barriers, and interpersonal influences); and the behavioral outcomes (health-promoting behaviors), and health status in community-dwelling whites and blacks 65 years of age and older? The convenience sample of 1 13 participants from four congregate meal sites in Central Virginia represented 46% of the young-old (aged 65 to 74 years); 83% females, 76% blacks, and 43% less than high school educated. Twenty-one percent had an annual household income of $4,999 or less, and 3 1% reported having an income between $10,000 and $14,999. The demographic questionnaire, the Perceived Health Competence Scale, the Barriers Scale, the Health promoting Lifestyle Profile-11, the Lubben Social Network Scale, and the Short Form-120, Version 2 Health Survey were used to collect data. These participants reported high perceived self-efficacy (Mean = 37.35, SD = 6-76), which was positively related to a health-promoting lifestyle (r = 0.20, p<0.05), physical health (r = 0.25, p< 0.05), and mental health status (r = 0.4 1, p<O.O 1). They Perceived few barriers to health-promoting behaviors (Mean = 37.22, SD = 6.63). However, perceived barriers were not significantly related to health-promoting lifestyle (r = -0.10, F0 .05) . Perceived barriers were inversely related to physical health (r = -0 .33 ,~~0 .01) , and mental health (r = -0.46,p<0.01). The participants had good social supports and their living arrangements were satisfiing (Mean = 28.12, SD = 8.62). These interpersonal influences were positively related to health-promoting lifestyle (r = 0.26, p<O.O 1), and mental health (r = 0.2, p<0.05). The relationship between interpersonal influences and physical health status was not significant. A healthpromoting lifestyle was often practiced (Mean = 154.70, SD = 18.80). Spiritual growth (Mean = 3.01) and interpersonal relations (Mean = 2.91) were frequently practiced behaviors; health responsibility (Mean = 2.6 1) and physical activity (Mean = 2.2 1) were the least practiced behaviors. Age, race, education, and income were not related to health-promoting lifestyle. However, females practiced healthier lifestyles compared to males ( t = -3.18, p = 0.0 1). No significant relationship was found between physical health and health-promoting lifestyle. A significant relationship was found between mental health and health-promoting lifestyle (r = 0.22, p<0.05). Further, the health status of participants was good; however, they perceived better mental health (Mean = 53.60, SD = 9.67) compared to physical health (Mean = 43.11, SD = 8.82). There were no significant differences in mental health based on age group, gender, race, and education. Significant differences were found in mental health based on income (F = 4.26, p = 0.0 1). Those with annual household incomes of $20,000 to $24,999 and $15,000 to $19,999 reported better mental health than those with incomes of $4,999 or less. Multiple regression analyses (N = 96) revealed that age and perceived barriers were predictors of physical health (R2 = 0.15, F = 8.03, p = 0.0 1). Perceived self-efficacy and perceived barriers were the predictors of mental health (R2 = 0.29, F = 18.74, p = 0.0 1).