Nadine Smith: Psychological predictors of successful ageing in a cohort of Australian women.
Research into the psychological characteristics that predict well-being in older age is of increasing relevance at a social and policy level. Life expectancy is increasing and at the same time pressure is increasing on the public resources required to support the frail elderly. The current research project examines the extent to which the intrapersonal factors of optimism and health-related hardiness explain the variance in older women's subjective health and well-being, and perceived stress. A review of the literature led to the hypothesis that; after controlling for physical health status, socioeconomic status, social support and access to health care; optimism and health-related hardiness would be significantly related to better subjective health and well-being, and lower stress in older Australian women.
The study sample comprised of 9,501 women aged between 73-78 years in 1999, who participated in the second phase of data gathering of the Australian Longitudinal Study on Women's Health. The outcome variables of subjective health were examined using the eight subdimensions of the SF-36. The outcome variable of perceived stress was examined using a seven item stress scale. The explanatory variables optimism and health-related hardiness were examined using the revised Life Orientation Test (LOT) and the Health-related Hardiness Scale, respectively. The control variables of physical health, socioeconomic status, social support and health care access were examined by health outcomes and demographic survey. Data were analysed using descriptive statistics, Chi-sqaure analysis, Pearson correlations, factor analysis, multiple regression and structural equation models. The results of the factor analysis of the revised LOT produced two distinct factors associated with optimism and pessimism.
The results of the factor analysis of the Health-related Hardiness Scale produced two factors, one associated with the positively phrased items and one with the negatively phrased items from this scale. Multiple regression established that optimism, pessimism, and health-related hardiness explained approximately 12% of the variance in older women's general health and mental health SF-36 scores, over and above that explained by physical health, socioeconomic status, social support and health care access. Structural equation models fitted using Lisrel techniques revealed moderate relationships between optimism, pessimism and hardiness, and the outcome variables representing the constructs of general health and mental health. These relationships provide general confirmation of the regression analysis. However, the structural models did not support the inclusion of the control variables associated with socioeconomic status, social support and health care access.
Methods suggested to improve the study include developing more finely differentiated measures of objective health and the proxies used to measure socioeconomic status, social support and health care access. It is important that the control variables used in fitting statistical models reflect, as closely as possible, the conditions they purport to measure so that appropriate statistical allowances for these conditions can be built into the most statistically rigorous models. The study demostrated that optimism; pessimism and hardiness amongst older Australian women were factors with modest but significant influences over subjective health and levels of perceived stress. Older women who are more optimistic, less pessimistic and more hardy, report better subjective health and lower levels of perceived stress than others in their age cohort. These findings have implications for health care professionals, families and others working with the aged in terms of providing social and emotional support which will in turn bring benefits for the well-being of older women. There is also support in these findings for the development of specific intervention programs to enhance feelings of optimism and health-related hardiness, and mitigate pessimism. The development and evaluation of support programs is one important avenue for further research. The insight gathered through the current research project contributes at least in a small way to understanding the issue of ageing among Australian women.