Philadelphia Geriatric Morale Scale Research Articles

Sexual satisfaction and aging satisfaction among middle-aged and older adults. Evidence from a nationally representative study

AimTo examine the association between sexual satisfaction and aging satisfaction (also stratified by sex and age group). MethodsWe used data from the German Ageing Survey (year 2008, n = 5,418 individuals). This is an established, nationally representative sample of individuals living in private households aged 40 years and over in Germany. The widely used “Attitudes Toward Own Ageing” (ATOA) subscale of the established Philadelphia Geriatric Morale Scale was used to quantify aging satisfaction. It was adjusted for several covariates in regression analysis. ResultsAfter adjusting for sociodemographic and health-related covariates, multiple linear regressions still showed that higher sexual satisfaction was associated with higher aging satisfaction in the total sample (β = 0.06, p < .001). This association was also present among both sexes (men, β = 0.07, p < .001; women, β = 0.06, p < .001) as well as among both age groups (middle-aged adults: β = 0.07, p < .001; older adults: β = 0.06, p < .001). ConclusionsEven after adjusting for several covariates, there is a clear link between sexual satisfaction and aging satisfaction. Such knowledge may assist in maintaining satisfaction with aging and may thus contribute to successful aging.

Accepting the inevitable: A mixed method approach with assessment and perceptions of well-being in very old persons within the northern Sweden Silver-MONICA study

BackgroundAs the group of very old persons will form an increasing part of society, the study of how well-being is described and affected by specific factors will be of importance to meet the future needs of these persons. The aim of the study was to increase knowledge of well-being in very old persons by combining assessments and perceptions using the Philadelphia Geriatric Morale Scale (PGCMS). MethodIn a mixed method, convergent parallel design, 52 persons 80 years or older were assessed and interviewed using the PGCMS to combine assessment of morale and descriptions of perceptions of well-being using a mixed method approach. ResultsQuantitative and qualitative results converged in four areas: not feeling lonely and being included, rating and perceiving health as good, high physical function/ability and being physically active, living in own house and feeling at home. Areas perceived as important to well-being captured only in qualitative analysis were having freedom and engagement. An example of insights not achievable from the quantitative or qualitative analysis alone was that individuals with high morale expressed anxiety about losing their health due to potential ageing-related threats and that individuals with low morale struggled with acceptance. Acceptance was the key strategy for handling adverse consequences of ageing in all described areas. ConclusionWhen using standardized assessment scales in clinical practice, it could be useful to combine quantitative and qualitative data. Acceptance was key for well-being; however, acceptance could be resigned or reorienting in nature.

Attitude Toward Own Aging Among Older Adults: Implications for Cancer Prevention.

Negative age stereotypes can become internalized and contribute to lower levels of physical and mental well-being in older adults, including those with serious illnesses. The main objective of this study was to examine the relationships of attitude toward own aging (ATOA) with health outcomes after controlling for resilience among older cancer survivors and comparison subjects without cancer, aged 50 years or older. We examined data in 1,140 adults from the Successful Aging Evaluation (SAGE) study, a structured multi-cohort investigation of community-based adults selected using random digit dialing. There were 219 participants with cancer (excluding skin cancer) and 912 without cancer. ATOA was assessed with the Philadelphia Geriatric Morale Scale, and its relationship with measures of physical, cognitive, and mental health, as well as resilience was evaluated. Individuals with cancer reported slightly more pessimistic ATOA than individuals without cancer. ATOA correlated with physical and mental health in individuals with and without cancer. Hierarchical linear multiple regression revealed that ATOA contributed significantly to the prediction of physical and mental health after controlling for socio-demographic variables and resilience. Higher levels of positive ATOA appear to be a protective factor for health in older adults, including those with cancer. Interventions that provide education about positive aspects of aging, modify negative automatic thoughts, and promote optimism may be useful for increasing ATOA and thereby improving physical and mental health in older adults, especially those with cancer.

Administering questionnaires to older people: Rigid adherence to protocol may deny and disacknowledge emotional expression

This paper draws on data from a larger study conducted in care home facilities in: Seattle, USA; West Sussex and Surrey in the UK; and in the lower North Island in New Zealand. Two extracts from interactions between the researchers and an older person during the administration of The Philadelphia Geriatric Morale Scale in a care home facility in New Zealand were analysed following Houtkoop-Steenstra and using a Conversation Analysis (CA) approach. In the first extract the audio-recorded transcript was examined for events of institutional talk and rephrasing of questionnaire questions. We also examined the transcript for missed cues and the impact of closed questions when administrating questionnaires to older people living in care home facilities. We then present an extract where the researcher uses a conversational approach during the administration of the same questionnaire. We conclude that rigid adherence to interview protocols when administering questionnaires to older people who cannot complete these themselves disables the interviewer from interacting and engaging in a meaningful conversation or responding to cues that indicate distress or expressions of grief. The effect of this approach may deny and disacknowledge older persons' emotional experiences and for the older person the interview may not be a therapeutic encounter. Based on our analysis and experiences of conducting this research we support recommendations that a collaborative approach, allowing an interactional exchange between interviewer and respondent, be used when administering questionnaires to older people in care home facilities.

Impairment of kidney function and reduced quality-of-life in older people: a cross-sectional study

to assess the association of kidney function with quality-of-life in community-dwelling older adults aged 75 years or more in the UK. cross-sectional study. primary care; 12 UK general practices participating in a cluster trial of health screening. estimated glomerular filtration rate (eGFR, ml/min/1.73 m(2)) using the four-variable modified diet in renal disease equation was derived in 1,195 men and 1,772 women with available bloods, these were 92% of 3,211 study participants who consented to interviews and 73% of those invited into the original cluster trial of health screening. interviews by trained fieldworker using the Sickness Impact Profile (home management, mobility, self-care, social interaction), and the Philadelphia Geriatric Morale Scale. Higher scores imply worse quality-of-life in a given domain. in age- and co-morbidity-adjusted analyses there was an association of eGFR <45 and the highest scores (defined as ≥median) of mobility (men: odds ratio (OR) 2.91, 95% confidence interval (CI) 1.56-5.41; women: OR 1.73, 95% CI 1.02-2.94), home management (men: OR 1.49, 95% CI 1.09-2.04; women: OR 3.50, 95% CI 1.18-10.35), social interaction (men: OR 3.34, 95% CI 1.73-6.45; women: 2.64, 95% CI 1.61-4.33) when compared with those with eGFR ≥60 and who reported no problems. Men with eGFR <45 had low morale (OR 2.45, 95% CI 1.02-5.87) but this was not found for women (OR 1.40, 95% CI 0.65-3.04), whereas women (but not men) with eGFR <45 reported problems with body care (women: OR 1.68; 95% CI 1.25-2.27: men: OR 0.89, 95% CI 0.55-1.46). an eGFR <45 is associated with poorer quality-of-life at older age. More research is needed to identify modifiable causes to improve quality-of-life in older people with such a degree of kidney function impairment.

Attitude toward own aging and mental health in post-menopausal women

Introduction Attitudes toward own aging (ATOA) refers to expectations about the personal experience of aging. As of now, there is limited literature that addresses the impact of ATOA on indicators of psychological, physical, and social health. In this study, we examine associations between ATOA and several measures associated with successful aging. Methods A detailed cross-sectional survey questionnaire on successful aging was completed by 1973 older women enrolled in the San Diego site of the Women's Health Initiative study. ATOA was measured using the Philadelphia Geriatric Morale Scale (PGMS). Results The final sample consisted of 1151 women. The mean ATOA score was 3.8 indicating generally positive ATOA. Positive ATOA score was significantly associated with younger age, lower income, being married, higher Short Form-36 Physical Composite Scores, higher Short Form-36 Mental Composite Scores, lower depression scores, and higher resilience scores. Approximately 40% of variance in ATOA scores was explained by successful aging-related domain scores. Conclusions Better physical and emotional functioning, greater resilience and lower depression are associated with more positive ATOA. Associations with socio-demographic traits are complex. Modifying ATOA may have potential to impact a broad range of health and successful aging related outcomes.

Assessment of Factors Influencing Morale in the Elderly

BackgroundWe examined the relationship between morale measured by the Philadelphia Geriatric Morale Scale (PGC) and disability, social support, religiosity, and personality traits. Instruments predicting morale were then tested against PGC domains.MethodsThe study utilized a cross-sectional survey with a multistage cluster sampling design. Instruments used were disability (disease burden; WHO Disability Score-II, WHODAS-II), social support (Duke Social Support Scale, DUSOCS; Lubben Social Network Scale, LSNS-6; Medical Outcomes Study Social Support Survey, MOS-SSS), religiosity (Revised Intrinsic-Extrinsic Religious Orientation Scale, I/E-R), and personality (Ten-Item Personality Inventory, TIPI). These were plotted as bar charts against PGC, resolved with one-way ANOVA and Kruskal-Wallis tests, then corrected for multiple comparisons. This process was repeated with PGC domains. Contribution of factors was modeled using population attributable risk (PAR) and odds ratios. Effect of confounders such as gender, age, and ethnicity were checked using binary logistic regression.ResultsAll instruments showed clear relationships with PGC, with WHODAS-II and DUSOCS performing well (ANOVA p<0.001). For PGC domains, attitude toward aging and lonely dissatisfaction trended together, while agitation did not. PAR, odds ratios, and Exp(β) were disability (WHODAS-II: 28.5%, 3.8, 2.8), social support (DUSOCS: 28.0%, 3.4, 2.2), religiosity (I/E-R: 21.6%, 3.2, 2.1), and personality (TIPI: 27.9%, 3.6, 2.4). Combined PAR was 70.9%.ConclusionsDisability, social support, religiosity, and personality strongly influence morale in the elderly. WHODAS-II and DUSOCS perform best in measuring disability and social support respectively.

Validity and reliability of the Philadelphia Geriatric Center Morale Scale among Turkish elderly people

We translated the original 17-item Philadelphia Geriatric Morale Scale (PGCMS) into Turkish and examined its validity and reliability to determine whether it may used as a tool to measure quality of life (QOL) in a Turkish elderly sample people. The sample included 398 participants aged 65 years living in institutions. Participants who were cognitively impaired (Abbreviated Mental Test score less than 7) or who could not answer questions for other reasons were excluded. Preliminary analysis was conducted to investigate multicollinearity, univariate and multivariate outliers, normality, item difficulty and discriminatory power of individual items. Confirmatory factor analysis (CFA) was used to test the structure of the PGCMS. By means of convergent-divergent validity, correlations between PGCMS and Turkish SF-36, correlations between PGCMS and social support scores, and correlations between PGCMS and hopelessness scores were investigated. Reliability was based on internal consistency investigated by Kuder-Richardson-20 (KD-20) and item-total correlation. By means of multicollinearity, we deleted two items. Neither univariate nor multivariate outliers were found. No items showed skewness and kurtosis value greater than recommended. A model containing 15 of the PGCMS items was found to fit Turkish data perfectly. We identified three underlying factors including agitation, attitude toward own aging, and lonely dissatisfaction similar to original PGCMS's three-factor solution. There were strong correlations between PGCMS's subscales. The correlations with the physical and mental domain in SF-36, correlations between PGCMS and social support, and correlation between PGCMS and hopelessness supported construct validity. We found satisfactory evidence of internal consistency (KD-20 was 0.92 for total PGCMS and it ranged from 0.76 to 0.85 for subscales in the PGCMS) with item-total correlations ranging from 0.39 to 0.73. The PGCMS is a valid and reliable quality of life measure in elderly Turkish people.

Philadelphia Geriatric Morale Scale in essential tremor: A population‐based study in three Spanish communities

Essential tremor (ET) is associated with both functional disability and depression. Each could contribute to a poor sense of well-being and low morale. We hypothesized that morale would be lower in ET cases than controls. Using a population-based, cross-sectional design, morale was assessed in 187 ET cases and 561 matched controls living in three communities in central Spain using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0 [low morale]-17), which included three-dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging. The PGCMS score was lower in ET cases than controls (9.41 +/- 3.21 vs. 10.39 +/- 2.92, P < 0.001), as were the Agitation subscore (3.17 +/- 1.71 vs. 3.78 +/- 1.67, P< 0.001) and Lonely Dissatisfaction subscore (3.75 +/- 1.34 vs. 4.02 +/- 1.24, P < 0.05). Nearly one-half of the ET cases were classified as having low morale compared with only one-third of controls (P = 0.006). In a linear regression analysis adjusting for demographic factors and multiple comorbid conditions, ET cases had a lower log PGCMS score than controls (P < 0.001). Exclusion of participants on antidepressant medication did not change the results. Our results indicate that morale is significantly lower in community-dwelling ET cases than in matched controls. This lower morale could in part be a proxy for mild, untreated depression. It therefore seems important to detect and then possibly treat this problem to improve the psychological well-being of patients with this disease.

Area deprivation, social class, and quality of life among people aged 75 years and over in Britain

There is a shortage of research studies that assess how selected characteristics of neighbourhood and personal social circumstances contribute towards health-related quality of life (QoL) among older people. Analysis of baseline data for 5581 people aged > or =75 years and over from the Trial of Assessment and Management of Older People in the Community. The scores for four dimensions from the UK version of the Sickness Impact Profile and for the Philadelphia Geriatric Morale Scale were analysed in relation to individual social class and the Carstairs score of socioeconomic deprivation for the enumeration district of residence. In age and sex adjusted analyses, the proportion of participants of social class IV/V living in the most deprived areas who were in the quintile with worst QoL scores was more than double that among those from social class I/II living in the least deprived areas. Individual social class and area deprivation score contributed roughly equally to this doubling for home management, self-care and social interaction, whereas social class appeared a stronger determinant for mobility. Adjustment for living circumstances, health symptoms, and health behaviours substantially reduced the excess risk associated with social class and area deprivation. Being in a rural area was associated with lower risk of poor morale. Poor socioeconomic characteristics of both the area and the individual are associated with worse functioning (QoL) of older people in the community. This is not fully explained by health status. Policy should consider community-level interventions as well as those directed at individuals.

Depression is the predominant factor contributing to morale as measured by the Philadelphia Geriatric Morale Scale in elderly Chinese aged 70 years and over

To examine factors contributing to the total Philadelphia Geriatric Morale Scale (PGMS) and its two subscales: reconciled ageing and unstrained affect. The PGMS was administered to 759 community-living subjects aged 70 years and over. Information regarding socioeconomic status, health conditions, sensory impairment, physical symptoms, social support, activities of daily living as measured by the Barthel Index, life satisfaction, and the Geriatric Depression Score, was collected. Associations between these factors and PGMS and its subscale were examined using univariate analysis (Mann-Whitney; Kruskal-Wallis tests), and multivariate analysis using the classification and regression tree (CART) method. Gender, old age, physical, socioeconomic and social factors were significantly associated with PGMS. There was a strong correlation with GDS (r = 0.77, p < 0.001). In the CART analysis, for both subscales and the total score, GDS was the predominant factor contributing to the score. Other factors include self perception of health, enough expenses, overall satisfaction with life, gender, and constipation. The PGMS and GDS are closely related. In addition to the GDS, health perception, life satisfaction, and adequate finance were factors contributing to quality of life in elderly Hong Kong Chinese.

Randomised controlled trial of effectiveness of Leicester hospital at home scheme compared with hospital care

Objective: To compare effectiveness of patient care in hospital at home scheme with hospital care.Design: Pragmatic randomised controlled trial.Setting: Leicester hospital at home scheme and the city's three acute hospitals.Participants:...

The Apparent Emotion Rating Instrument

ABSTRACT Assessing affect in cognitively impaired elders is difficult. A number of instruments have been developed to measure single emotions or more broad aspects of well-being. The Apparent Emotion Rating (AER) scale is an observational instrument that measures the presence or absence of three positive (pleasure, interest, and tranquility) and three negative emotions (anger, anxiety, and sadness). Interrater percentage of agreement ranged from 82% for anxiety to 100% for interest. A weak, but statistically significant correlation (r = .303, p =.000) was found with the Philadelphia Geriatric Morale Scale (Lawton, 1975). Elders with greater cognitive impairment had lower AER scores than did persons with higher scores. The AER is a promising tool for providing reliable and valid observational data about mood state, particularly in persons unable to respond to a self-report measure.

Effects of a Multi-Strategy Program Upon Elderly with Organic Brain Syndrome

The differential effects of a Multi-strategy Group Program and that of traditional nursing home care upon elderly residents with organic brain syndrome were measured using the Mental Status Questionnaire, the Face-Hand Test, the Philadelphia Geriatric Morale Scale, and Lowenthal's Langley-Porter Physical Self Maintenance Scale. Seventy two subjects with organic brain syndrome were assessed on morale, physical self-maintenance, and mental function before and after receiving the Multi-strategy Program or traditional nursing home care. Subjects in the Multi-strategy Programs showed significant improvement in morale, activities of daily living, and mental functioning following four months of intervention, while the traditional nursing home care group showed significant decrease in the same areas.

Age, Ethnicity, and Well-Being

In this article we reexamine the issue of age differences in well-being, focusing on ethnic variations in this relationship. Data are from 1269 Los Angeles residents (407 Anglos, 413 blacks, and 449 Mexican Americans) between the ages of 45 and 74. Two measures of well-being were analyzed: Lawton's Philadelphia Geriatric Morale Scale and a single-item indicator of happiness. Results suggest that: (1) The overall relationship between age and well-being is strongly positive for Anglos, once controls are introduced for sex, marital status, income, health, and schooling; and (2) the slope of the relationship between age and well-being is similar for blacks and Anglos, but much smaller for Mexican Americans. Results suggest clear ethnic differences in the net advantage that advancing age offers to well-being. The relevance of the findings for the double-jeopardy hypothesis is discussed.

Level of aspiration, life satisfaction, and locus of control in older adults.

The relationship of the level of aspiration disparity score to life satisfaction and locus of control in two groups of aged individuals, the young-old (ages 60 to 69) and the old-old (ages 70-79) was studied. Female volunteers (N = 100) between the ages of 60 and 79, who were living in the community and were relatively well functioning, were administered The Rotter Level of Aspiration Test, The Life Satisfaction Index A, The Philadelphia Geriatric Morale Scale, The Internal-External Scale, and The Health Locus of Control Scale. Partial support was found for the hypothesis that a positive disparity score is associated with increased life satisfaction and a more internal locus of control.

AGING, REMINISCENCE AND LIFE SATISFACTION

Reminiscence. or recalling the past, is a behavior common to all ages. Research todate, however, has been conductedonly with olderadults and has failed to clearly delineate how reminiscence might be related to self-esteem. cognitive functioning, or lifesatisfaction. This study focused upon the relationship between life satisfaction and the reminiscent behavior of 309 students, young adults, middle-aged men and women and older adults. Life satisfaction scores were obtained by summing responses to the 17-items of the Philadelphia Geriatric Morale Scale. Two factors, Coping and Enjoyment, were derived from eleven statements regarding feelings subjects reported having while reminiscing. Multiple regression analysis revealed a weak though statistically significant (a = .01) relationship between life satisfaction and the two factors. Those who placed greater emphasis upon reminiscence as enjoymcnr tended to have higher lice satisfaction scores. Conversely, those who had highei scores on using reminiscence for c...