Ageing populations and the unique challenges they pose are characteristic of the accelerating demographic transition evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). The influx of the baby boomer generation will inevitably lead to an exponential increase in the numbers of white older people within the next two decades. Regardless of integration policies in post-apartheid South Africa, 90% of all residential care facilities are still occupied solely by white older people. Such facilities are described as buildings or other structures used primarily for the purposes of providing accommodation and of providing a 24-hour service to older persons. The increasingly larger segment of white older people holds considerable implications for the future of these facilities since more individuals will turn to this living arrangement. The Older Persons Act of South Africa was inaugurated by the government in 2006 and its key objectives are aligned with the recommendations of the Madrid International Plan of Action on Ageing (2002). Amongst many other objectives, the Older Persons Act emphasises practices that enhance the wellbeing and quality of life (QoL) of all older persons. However, the reigning circumstances in most residential care facilities have been described as challenging. A national audit of residential care facilities in 2010 indicated a need for psychosocial interventions since the QoL of residents was found to be undefined and unspecific. The purpose of the study was to explore the construction of QoL, from the perspective of the older people living in residential care facilities. A purposive sample of 54 participants (male, n=10; female, n=44) with ages ranging between 62 and 95 years was drawn. The participants were able to communicate congruently and understood the research purpose. Participants resided in four similar facilities situated in urban areas in two South African provinces. A multiple-context inquiry was conducted to gather rich data and collateral information. The study made use of interviews, focus groups, journals, and the Mmogo-method® to collect qualitative data. Interpretative Phenomenological Analysis (IPA) and visual analysis methods were used to analyse the data. Interactive Qualitative Analysis (IQA) was conducted with 19 participants, resulting in a conceptual model of QoL. Member-checking was performed by the participants. Ethical approval was granted by the Ethics Committee of the North-West University (Potchefstroom Campus), as part of a larger project, namely “An exploration of enabling contexts (05K14)”. The findings revealed that the nature of QoL is informed by spiritual worldviews, interpersonal contexts and the maintained ability of older people to regulate aspects of their own lives. The nature of QoL was also revealed as transitional throughout the ageing process and that the dimensions of QoL may be found on a continuum. Six domains were elicited in the construction of QoL, namely spirituality, health, relationships, meaningfulness, autonomy and sense of place. Each domain presented with certain contributors and inhibitors influencing the older person’s ability to experience QoL. Findings revealed the strengths of older people to deal with adversities associated with later life. The inhibitors of QoL are emphasised for the attention of policy makers, the managers of residential care facilities, care givers and family members. The study provided insight into the causal influences between the domains of QoL. A conceptual model with systemic properties is proposed. The theoretical implications of this systems model are that QoL domains are mutually informing and exercise a particular influence on the relational states of older people. It is hoped that new knowledge in the area of QoL might direct future research efforts and put resources channeled to residential care facilities to better use. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013.

Ageing populations and the unique challenges they pose are characteristic of the accelerating demographic transition evident in both developed and developing countries. In South Africa the elderly population is also increasing dramatically. There is a disproportionate distribution of older persons per ethnic group, with white older people representing the largest group of older South Africans (21%, proportional to ethnic group). The influx of the baby boomer generation will inevitably lead to an exponential increase in the numbers of white older people within the next two decades. Regardless of integration policies in post-apartheid South Africa, 90% of all residential care facilities are still occupied solely by white older people. Such facilities are described as buildings or other structures used primarily for the purposes of providing accommodation and of providing a 24-hour service to older persons. The increasingly larger segment of white older people holds considerable implications for the future of these facilities since more individuals will turn to this living arrangement. The Older Persons Act of South Africa was inaugurated by the government in 2006 and its key objectives are aligned with the recommendations of the Madrid International Plan of Action on Ageing (2002). Amongst many other objectives, the Older Persons Act emphasises practices that enhance the wellbeing and quality of life (QoL) of all older persons. However, the reigning circumstances in most residential care facilities have been described as challenging. A national audit of residential care facilities in 2010 indicated a need for psychosocial interventions since the QoL of residents was found to be undefined and unspecific. The purpose of the study was to explore the construction of QoL, from the perspective of the older people living in residential care facilities. A purposive sample of 54 participants (male, n=10; female, n=44) with ages ranging between 62 and 95 years was drawn. The participants were able to communicate congruently and understood the research purpose. Participants resided in four similar facilities situated in urban areas in two South African provinces. A multiple-context inquiry was conducted to gather rich data and collateral information. The study made use of interviews, focus groups, journals, and the Mmogo-method® to collect qualitative data. Interpretative Phenomenological Analysis (IPA) and visual analysis methods were used to analyse the data. Interactive Qualitative Analysis (IQA) was conducted with 19 participants, resulting in a conceptual model of QoL. Member-checking was performed by the participants. Ethical approval was granted by the Ethics Committee of the North-West University (Potchefstroom Campus), as part of a larger project, namely “An exploration of enabling contexts (05K14)”. The findings revealed that the nature of QoL is informed by spiritual worldviews, interpersonal contexts and the maintained ability of older people to regulate aspects of their own lives. The nature of QoL was also revealed as transitional throughout the ageing process and that the dimensions of QoL may be found on a continuum. Six domains were elicited in the construction of QoL, namely spirituality, health, relationships, meaningfulness, autonomy and sense of place. Each domain presented with certain contributors and inhibitors influencing the older person’s ability to experience QoL. Findings revealed the strengths of older people to deal with adversities associated with later life. The inhibitors of QoL are emphasised for the attention of policy makers, the managers of residential care facilities, care givers and family members. The study provided insight into the causal influences between the domains of QoL. A conceptual model with systemic properties is proposed. The theoretical implications of this systems model are that QoL domains are mutually informing and exercise a particular influence on the relational states of older people. It is hoped that new knowledge in the area of QoL might direct future research efforts and put resources channeled to residential care facilities to better use. / Thesis (PhD (Psychology))--North-West University, Potchefstroom Campus, 2013.

Avec près d'un million de cas de démence en France en 2010, la maladie d'Alzheimer (MA) et les syndromes apparentés constituent un enjeu majeur de santé publique. A l'heure actuelle, il n'existe aucun traitement médicamenteux permettant de guérir de la MA. Ces médicaments visent à ralentir la progression de la maladie en améliorant certains symptômes. De ce fait, il semblait utile et nécessaire de disposer d'indicateurs permettant d'évaluer les prises en charge mises en place pour ces patients. La qualité de vie liée à la santé (QDV) est donc devenue un critère d'évaluation indispensable tant pour les chercheurs que pour les cliniciens.Les outils de QDV génériques sont en général moins sensibles pour une maladie donnée. C'est pourquoi d'autres outils spécifiques à la MA se sont développés. Aucun parmi eux n'était validé en langue française. L'objectif de cette thèse était donc, après une revue de la littérature, de réaliser la validation transculturelle puis psychométrique du « Quality of Life in Alzheimer's Disease » (QoL-AD) et du « Dementia Quality of Life » (DQoL). Ces deux questionnaires étaient d'après la littérature les plus utilisés en langue anglaise dans cette maladie.Ce travail de thèse a été réalisé sur les données du PHRC National 2004 « Evaluation de la qualité de vie chez le sujet âgé dément : validation d'un instrument spécifique ». Cette étude a permis de recueillir des données d'un total de 155 couples patient-aidant recrutés au sein de sept centres hospitaliers français et d'un centre suisse francophone participant à l'étude. Les patients présentaient une MA au stade léger ou stade modéré (Mini Mental State Examination > ou = 10). Le QoL-AD et le DQoL ont été administrés par un enquêteur. Le QoL-AD aidants a été auto-administré. L'adaptation transculturelle puis la validation psychométrique ont donc été réalisées pour ces deux questionnaires.Nous disposons donc désormais d'une version française du QoL-AD et d'une version française du DQoL, ayant bénéficié d'une adaptation transculturelle effectuée selon les recommandations internationales, et qui présentent toutes deux de bonnes propriétés psychométriques. / With nearly one million cases of dementia in France in 2010, Alzheimer's disease (AD) and related syndromes are a major public health issue. Up to now, there is no drug for treatment or preventing for AD. The only available drugs aim to slow down the progression of the disease by improving some symptoms. Therefore, it seemed necessary to have indicators enabling assessment of treatment strategies for these patients. So, health related quality of life (HRQoL) became an essential criterion for evaluation for both researchers and clinicians.Generic HRQoL tools are generally less sensitive for a given disease. That is why other specific tools for AD have been developed. None of them was validated in French. The aim of this thesis was therefore, after a review of the literature, to achieve a cross-cultural adaptation and psychometric validation of the "Quality of Life in Alzheimer's Disease" (QoL-AD) and "Dementia Quality of Life" (DQoL). These two questionnaires were selected because they were the most popular in English-language literature for this disease.This thesis was conducted on data collected during the PHRC National 2004 "Evaluation of the quality of life in elderly demented people: validation of a specific instrument". This study concerned a total of 155 patient-caregiver pairs recruited from seven French hospitals and a Francophone Swiss center. Patients had a confirmed diagnosis of AD (mild to moderate stage: Mini Mental State Examination > ou = 10). QoL-AD and DQoL were administered by an interviewer. The caregiver sheet of QoL-AD was self-administered. Cross-cultural adaptation and psychometric validation have been carried out for these two questionnaires.We now have at disposal two HRQoL questionnaires specifics for AD in French language. They are issued from a cross-cultural adaptation performed according to international quidelines and both have good psychometric properties. So they can be used to evaluate quality of life in Alzheimer's disease on French speaking population.

Bakgrund: Att leva med epilepsi har en fysisk och psykisk påverkan på livet. Huvudfokus har länge legat på att behandla själva anfallen men hur livet och livskvaliteten påverkas i ett heltäckande perspektiv är lika viktigt. Det finns ett kunskapsglapp om epilepsi som leder till osäkerhet kring diagnosen och bidrar till att fördomar, diskriminering och stigmatisering lever kvar. Vi vill undersöka hur personer med epilepsi upplever att leva med diagnosen, för att bidra till ett bättre bemötande och en ökad livskvalitet. Syfte: Studiens syfte är att undersöka hur människors livskvalitet påverkas av att leva med epilepsi. Metod: Litteraturöversikt med kvalitativa och kvantitativa vetenskapliga artiklar. Artiklarna analyserades med WHO:s definition av livskvalitet med dess sex olika domäner som utgångspunkt. Resultat: Livskvaliteten påverkades negativt för personer med epilepsi inom samtliga domäner. Positiva aspekter återfanns under flera domäner men inte i samma omfattning som de negativa. Det psykiska välbefinnandet var den viktigaste komponenten för livskvalitet. De övriga domänerna hade en viktig roll i hur utfallet för det psykiska välbefinnandet blev. Slutsats: Livskvalitet för personer med epilepsi är beroende av det psykiska välbefinnandet, positiva och negativa aspekter påverkar det psykiskt välbefinnande och därmed livskvaliteten. Förändring av epilepsisjukvården med ett större fokus på det psykiska välbefinnandet skulle öka livskvaliteten för många personer med epilepsidiagnos. / Background: Living with epilepsy have a physical and psycohological impact on life. For a long time main focus has been on treating the seizures, but how life and the quality of life is effected for people with epilepsy in a broad perspective is equally important. There is a knowledge-gap about epilepsy that leads to uncertainty around the diagnosis and contributes to the prejudices, discrimination and stigmatization that surrond epilepsy lives on. We want to examine how peolpe with epilepsy experience living with epilepsy, to contribute to better treatment and a increased quality of life. Aim: The aim of this study is to examine how peoples quality of life is affected by living with epilepsy. Method: A literature review based on qualitative and quantitative studies. The collected data is analyzed using WHOs’ definition of quality of life with its six domains as a foundation.  Results: The quality of life was negatively affected for peolpe with epilepsy in all of the domains. Positive aspects was found in several domains, but not in the same extent as the negatives were. The psychological well-being was the most important component for quality of life and the other domains had a significant roll regarding the outcome of the psychological well-being. Conclusion: The quality of life for people with epilepsy is dependent on the psychological well-being, with positive and negative aspects affecting the psychological well-being and thereby the quality of life. A change of the care for people with epilepsy with more focus on the mental health would increase the quality of life for many persons with a epilepsy diagnosis.

A crescente importância da QV enquanto desfecho em saúde fez o grupo WHOQOL, da OMS, elaborar medidas de avaliação de QV para utilização internacional. Com a necessidade de instrumentos menores que demandassem pouco tempo para o preenchimento, foi desenvolvido o EUROHIS-QOL 8-ITEM, originado dos itens do WHOQOL- BREF. Objetivos: Testar as propriedades psicométricas do EUROHIS-QOL 8-ITEM em uma amostra brasileira. Métodos: A amostra foi constituída de 325 indivíduos. Eles foram divididos em dois grupos, 151 indivíduos constituiram o grupo dos doentes do Hospital de Clínicas de Porto Alegre, RS, e 174 o grupo dos saudáveis. Para a avaliação das propriedades psicométricas do índice EUROHIS-QOL 8-ITEM, foram realizadas algumas análises. A Consistência Interna, foi avaliada usando o Alpha de Cronbach. A validade discriminante foi avaliada comparando o grupo de doentes e saudáveis e também o de deprimidos e não-deprimidos. A análise da validade convergente ocorreu através da correlação do EUROHIS-QOL 8-ITEM com diferentes medidas de QV já validadas e reconhecidas, o SF-36 e o WHOQOL-BREF. A análise fatorial foi avaliada usando o modelo de equação estrutural (SEM). Avaliou-se a unidimensionalidade usando as propriedades do modelo de Rasch. Resultados: A consistência interna avaliada pelo Alpha de Cronbach (com valor de 0,81) monstrou-se boa. O índice EURO-HIS–QOL 8-ITEM também mostrou boa capacidade discriminativa entre os grupos de doentes e saudáveis (média1=3,32; DP1=0,70; média2=3,77; DP2=0,63 t =6,12, p < 0,001) e também entre os grupos de deprimidos e não deprimidos (média3=3,14; DP3=0,69; média4=3,72; DP4=0,61 t = 7,25 p <0,001). O instrumento demonstrou boa validade convergente, através de correlações significativas (p < 0,001) entre o EUROHIS-QOL 8-ITEM e todos os domínidos do WHOQOL- BREF (QV Geral r = 0,47; Saúde Geral r= 0,54; Físico r = 0,69; Psicológico r = 0,62; Relações Sociais r = 0,55; Meio Ambiente r = 0,55) e entre o EUROHIS-QOL 8-ITEM e os domínios do SF-36 (QV Geral r = 0,36; Capacidade Funcional r =0,49; Limitação Física r = 0,45; Dor r = 0,43; Saúde Geral r = 0,52; Vitalidade r = 0,21; Aspectos Sociais r = 0,45; Aspectos Emocionais r = 0,38 e Saúde Mental r = 0,17), com exceção do domínio social (p = 0,38). Na análise de Rasch, as medidas de ajuste geral do modelo apresentaram adequado desempenho estatístico e foi considerado um bom ajuste logo na primeira avaliação (Ajuste de resíduo Interação Item pessoa: M= 0,01 e DP= 1,51; ajuste de resíduo de pessoa: M = -0,38 e DP= 1,19 e Item traço: Item total X²=69,60 p=0,00. Personal Separation Index = 0,82), ou seja, os resíduos foram aceitáveis, não foi preciso excluir itens. O EUROHIS-QOL 8-ITEM, apresentou bom ajuste aos dados na análise fatorial confirmatória (X²= 18,46; DF= 15; CFI= 0,99; RMSEA= 0,03; GFI = 0,99; RMR=0,03; P = p,24). Conclusão: O EURHIS-QOL 8-ITEM, validado em amostras europeias apresentou adequadas propriedades psicométricas neste estudo, mostrando-se uma medida confiável de QV para ser usada em amostras brasileiras. / In the 70s, quality of life began to be considered a health outcome. With the growing importance of this assessment in different areas of medicine, there were no instruments developed in the cross-cultural perspective for international use. In this context, quality of life assessement outcome measures were developed by the WHOQOL group from WHO. With the need of shorter instruments which demanded less time to be filled in, the EUROHIS-QOL 8 ITEM was developed, originated from WHOQOL-BREF items. Objectives: Test the psychometric properties of EUROHIS-QOL 8-ITEM in a Brazilian sample. Methods: The sample consisted of 325 individuals. They were divided in to two groups, 151 subjects constituted the group of patients from the Hospital de Clinicas de Porto Alegre, RS, and 174 subjects the group of healthy controls. Some analyses were performed for the assessment of the psychometric properties of EUROHIS-QOL 8-ITEM index. Internal consistency was measured by using Cronbach’s alpha. Discriminant validity was assessed by comparing the group of patients and healthy controls and also the depressed and nondepressed. Analysis of convergent validity was through the correlation of EUROHIS-QOL 8-ITEM with different quality of life measures already validated and recognized as the SF-36 and WHOQO-BREF. Factor analysis was assessed using structural equation model (SEM). Unidimensionality was assessed using the properties of the Rasch model. Results: The Cronbach's alpha showed good internal consistency (with a value of 0.81). The measure also showed good discriminative ability between the groups of patients and healthy controls (mean1=3.32; SD1=0.70; mean2=3.77; SD2=0.63 t =6.12, p = 0,00) and between the depressed and nondepressed groups (mean3=3.14; SD3=0.69; mean4=3.72; SD4=0.61 t = 7.25 p =0.00). The instrument showed good convergent validity through significant correlations ( p < 0.001 ) between the EUROHIS–QOL 8-ITEM and all domains of WHOQOL-BREF (QV Overall r = 0.47; General Health r= 0.54; Physical Health r = 0.69; Psychological Health r = 0.62; Social Relationship r = 0.55; Meio Environment r = 0.55) and between EUROHIS-QOL 8-ITEM and the domains of the SF-36 (QV Overall r = 0.36; Functioning Physical r =0.49; Role Physical r = 0.45; Bodily Pain r = 0.43; General Health r = 0.52; Vitality r = 0.21; Social Functioning r = 0.45; Role Emotional r = 0.38 and Mental Health r = 0.17) , except for the social domain ( p = 0.38). In the Rasch analysis, general fit measures of the model had adequate statistical performance and were considered a good fit at the first assessment (residual fit Item-person Interaction: M = 0.01, SD = 1.51; person residual fit: M = -0.38, SD = 1.19 and Item-trait: Total Item X² = 69.60 p = 0.00. Personal Separation Index = 0.82), that is, the residuals were acceptable, it was not necessary to exclude items. The EUROHIS-QOL 8-ITEM showed a good fit to the data in the confirmatory factor analysis (X² = 18.46, DF = 15; CFI = 0.99; RMSEA = 0.03; GFI = 0.99; RMR = 0.03; P = 24). Conclusion: EUROHIS-QOL 8-ITEM, validated in European samples, showed adequate psychometric properties in this study showing to be a reliable quality of life measure to be used in Brazilian samples.

<p><strong>Syftet</strong> med litteraturstudien var att beskriva vad starkt respektive svagt KASAM betyder för livskvalitet, välbefinnande och hälsa bland äldre (60 år och äldre). Studien designades med en deskriptiv ansats. <strong>Metoden</strong> var att systematiskt söka litteratur i databaserna; Medline, CINAHL samt Vård i Norden, detta kompletterades även med manuella sökningar. Femton artiklar som motsvarade syftet och inklusionskriterierna granskades och analyserades. <strong>Resultatet</strong> visade att KASAM hade signifikanta samband med de äldres upplevda livskvalitet, välbefinnande och hälsa. Antalet sjukdomar och fysiska begränsningar hade en liten inverkan på de äldre om de hade ett starkt KASAM, då KASAM hade ett svagt samband med den objektiva hälsan och ett starkt samband med den subjektiva hälsan. KASAM var den faktor som bäst förutsåg hur de äldre upplevde sin livssituation. De äldre som hade ett starkt KASAM upplevde även tillfredställande socialt stöd, som hade en stor inverkan på deras välbefinnande. De äldre med svagt KASAM hade även låg livskvalitet och försämrat allmäntillstånd. <strong>Slutsatsen</strong> var att om vårdpersonal kan stärka de äldres KASAM kommer även de äldres livskvalitet, välbefinnande och hälsa förbättras.</p>

<p>Amyotrophic lateral sclerosis (ALS) is characterized by a progressive loss of upper and lower motor neurons, resulting in muscle weakness and death from respiratory failure within 3-5 years after onset. The incidence is 1.5-2.7/100,000 inhabitants. 5-10% of all cases are hereditary. The aetiology of sporadic ALS is still unknown. </p><p>The only neuroprotective drug approved for the treatment of ALS is riluzole, a glutamate-antagonist, which has shown to improve survival. We evaluated if riluzole sales statistics can be used as a method for estimating the prevalence of ALS/motor neuron disease in Sweden. We found that this method, which is less time consuming than conventional methods, could be used as a crude marker for the prevalence. </p><p>In a longitudinal study of overall Quality of Life (QoL) in ALS we found that QoL changes only slightly over time despite disease progression. ALS does not necessarily result in a low QoL. </p><p>Growth factors are important for the survival of neurons. In ALS we found increased or normal levels of GDNF mRNA and BDNF mRNA in muscle biopsies, VEGF in serum and spinal cord and FGF-2 in serum and cerebrospinal fluid. There is thus no deficit of these growth factors although there may be a relative lack because of high demands of the motor neurons. Polyamines are small aliphatic molecules that are important for the function of cells. The level of the polyamines spermidine and spermine were increased in red blood cells in both patients with ALS and patients with Parkinson’s disease, suggesting that polyamines may have a role for the neurodegenerative process. Polyamines in spinal cord were of the same level in the patients with ALS and in controls, indicating a maintained regulation of polyamines at the end-stage of the disease.</p>

Amyotrophic lateral sclerosis (ALS) is characterized by a progressive loss of upper and lower motor neurons, resulting in muscle weakness and death from respiratory failure within 3-5 years after onset. The incidence is 1.5-2.7/100,000 inhabitants. 5-10% of all cases are hereditary. The aetiology of sporadic ALS is still unknown. The only neuroprotective drug approved for the treatment of ALS is riluzole, a glutamate-antagonist, which has shown to improve survival. We evaluated if riluzole sales statistics can be used as a method for estimating the prevalence of ALS/motor neuron disease in Sweden. We found that this method, which is less time consuming than conventional methods, could be used as a crude marker for the prevalence. In a longitudinal study of overall Quality of Life (QoL) in ALS we found that QoL changes only slightly over time despite disease progression. ALS does not necessarily result in a low QoL. Growth factors are important for the survival of neurons. In ALS we found increased or normal levels of GDNF mRNA and BDNF mRNA in muscle biopsies, VEGF in serum and spinal cord and FGF-2 in serum and cerebrospinal fluid. There is thus no deficit of these growth factors although there may be a relative lack because of high demands of the motor neurons. Polyamines are small aliphatic molecules that are important for the function of cells. The level of the polyamines spermidine and spermine were increased in red blood cells in both patients with ALS and patients with Parkinson’s disease, suggesting that polyamines may have a role for the neurodegenerative process. Polyamines in spinal cord were of the same level in the patients with ALS and in controls, indicating a maintained regulation of polyamines at the end-stage of the disease.

Background: Elder abuse and its effects are a serious public health issue. However, little is known about therelation between psychological abuse, other factors (e.g. social support) and quality of life (QoL) by domain. This studyaddressed differences in QoL by domain between psychologically abused and non-abused. While considering otherfactors such as social support. Methods: The respondents were 4,467 (2,559 women) randomly selected persons aged 60-84 years living in7 European cities. The mean response across countries was 45.2%. The cross-sectional data were analyzed withbivariate/multivariate methods. Results: Abused respondents contrasted to non-abused scored lower in QoL (autonomy, 67.42 ± 21.26 vs. 72.39± 19.58; intimacy, 55.31 ± 31.15 vs. 67.21 ± 28.55; past/present/future activities, 62.79 ± 19.62 vs. 68.05 ± 18.09;social participation, 65.03 ± 19.84 vs. 68.21 ± 19.77). Regressions showed that abuse was negatively associated withautonomy, intimacy and past/present/future activities, and positively with the social participation. All QoL dimensionswere negatively associated with country and depressive/anxiety symptoms, and positively with social support. Further,variables such as age, sex and somatic symptoms were negatively associated with some of the QoL dimensions andothers such as family structure, education, health care use and drinking positively. The regression model “explained”32.8% of the variation in autonomy, 45.6% in intimacy, 44.8% in past/present/future activities and 41.5% in socialparticipation. Conclusions: Abuse was linked to lower QoL in most domains, but other factors such as depressive symptomsalso carried a negative impact. Social support and to some extent family structure had a “protective” effect on QoL.Abuse, health indicators (e.g. depressive symptoms) and social support should be considered in addressing the QoL ofolder persons. However, QoL was influenced by many factors, which could not be firmly disentangled due to the crosssectionalapproach, calling for longitudinal research to address causality.

Syftet med litteraturstudien var att beskriva vad starkt respektive svagt KASAM betyder för livskvalitet, välbefinnande och hälsa bland äldre (60 år och äldre). Studien designades med en deskriptiv ansats. Metoden var att systematiskt söka litteratur i databaserna; Medline, CINAHL samt Vård i Norden, detta kompletterades även med manuella sökningar. Femton artiklar som motsvarade syftet och inklusionskriterierna granskades och analyserades. Resultatet visade att KASAM hade signifikanta samband med de äldres upplevda livskvalitet, välbefinnande och hälsa. Antalet sjukdomar och fysiska begränsningar hade en liten inverkan på de äldre om de hade ett starkt KASAM, då KASAM hade ett svagt samband med den objektiva hälsan och ett starkt samband med den subjektiva hälsan. KASAM var den faktor som bäst förutsåg hur de äldre upplevde sin livssituation. De äldre som hade ett starkt KASAM upplevde även tillfredställande socialt stöd, som hade en stor inverkan på deras välbefinnande. De äldre med svagt KASAM hade även låg livskvalitet och försämrat allmäntillstånd. Slutsatsen var att om vårdpersonal kan stärka de äldres KASAM kommer även de äldres livskvalitet, välbefinnande och hälsa förbättras.