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Self-Reported Health among Community-Dwelling Older Adults: A Multimethod Study to Understand the Complexity and Role of Adaptation to Health Adversity

Self-reported health is typically captured as a response to the question, “In general, would you rate your health as excellent, very good, good, fair or poor?” Among community-dwelling older adults (≥65 years), self-reported health decreases as the number of chronic conditions increases. Despite this well-documented relationship, little is known about how other sociodemographic or health-related factors may shape this relationship, what may predict high self-reported health among this population, or how older adults perceive these factors as influencing their perceptions of health. Informed by the Lifecourse Model of Multimorbidity Resilience, the objective of this multimethod research study was to advance understanding of self-reported health among community-dwelling older adults. To this end, four research studies were completed: 1) scoping review of the factors associated with self-reported health, 2) cross-sectional analysis of baseline data from the Canadian Longitudinal Study on Aging to understand the relationship between multimorbidity and self-reported health and the factors that predict high self-reported health; 3) qualitative case study to explore the influence of individual, social, and environmental factors on self-reported health, including multimorbidity resilience, in community-dwelling older adults, and; 4) a multimethod study that brought together all findings in a matrix analysis. From this work, two meta-inferences were generated: 1) the factors that shape self-reported health are multidimensional and complex; and 2) adaptation to health adversity, resulting from experiences acquired over the lifecourse, shape how older adults perceive their health. Findings from this work advance three implications. First, there is a need to use and apply information gained by asking about self-reported health in clinical practice to inform care planning. Second, there is a need for whole person care to guide health and social care policy for older adults. Third, future health research must further explore longitudinal understanding of self-reported health as well as additional qualitative understanding of the differences of those older adults with the well-being paradox. / Dissertation / Doctor of Philosophy (PhD)

Identiferoai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/27446
Date January 2022
CreatorsWhitmore, Carly
ContributorsMarkle-Reid, Maureen, Nursing
Source SetsMcMaster University
LanguageEnglish
Detected LanguageEnglish
TypeThesis

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