Quality of life for the elderly: building an instrument that privileges their opinion. / Qualidade de vida do idoso: elaboração de um instrumento que privilegia sua opinião.

AUTOR(ES)
DATA DE PUBLICAÇÃO

2001

RESUMO

To live longer, what most people wish for nowadays can result in a life characterized by incapacity and dependency. The challenge is to be able to live longer, with a better quality of life. For health professionals who assist the elderly population, there is yet another challenge: how to measure quality of life, not only to have a clear picture of life among the elderly population, but mainly to assess the impact of treatment, procedures and policies, re-direct their goals, allocate resources and plan services, with the objective of achieving a better quality of life. Historically, after World War II, quality of life became an important concept, meaning the improvement in life standards. Gradually, the concept was extended, comprehending human and social-economic development and people’s perception of their own lives. There is no consensus on its meaning, and there are several currents which are complementary. Additionally, as time went by, the assessment technique changed, going from an objective parameter-based or researcher-based evaluation, to another type of evaluation which privileges people’s subjective perception. From 1975 on, quality of life assessments have been gradually incorporated into the Health Service practices. There are several instruments available for that, but few specifically built for the elderly population. In Brazil, the studies were broadened in 1992, and recently we have observed more consistent ones, which included translation, transcultural adaptation and validation of foreign questionnaires; studies on the elderly population’s quality of life are rare. It is clear the necessity of creating an instrument to measure the quality of life of elderly people, taking into account their opinion regarding issues they consider important. The aims of this study were: to specify the necessary procedures in order to build an assessment instrument to evaluate elderly people’s quality of life and define from the preliminary evaluation, the items that will constitute a list to be used in a future step for the definite conception of the instrument. In order to do so, we have used a methodological reference from the medical literature, which was adapted to our objectives. During the first step we built a preliminary list of items, which was tested through a previous investigation. This list was generated by using three sources: review of answers to a previous questionnaire, review of other instruments from the literature and our own clinical practice. The preliminary investigation consisted of three phases: the first one, which was spontaneous, where the interviewee pointed out items he/she considered relevant for a good and bad quality of life; the second one, which was stimulated, where the interviewee identified the relevance of the all other items in the preliminary list; and finally, the third phase, where he/she assessed the importance of the items considered to be relevant (Likert). The analysis of the procedures showed that the methodology is viable. We interviewed 19 elderly patients, 9 men and 10 women. The medians were: 82 minutes of interview duration, varying from 56 to 118 minutes; 13 items reported spontaneously, varying from 4 to 21; four items which were nor understood, varying from 0 to 9; 5 excluded items, varying from 0 to 21. The refusals to participate came from dependent elderly patients, which were actually the escort’s refusal. Two items that had been suggested during the spontaneous phase were incorporated and an item considered redundant was excluded. Eleven items that were not understood were rewritten. All items that were excluded will be kept for the next step. Likert’s scale will have to be redesigned. During a posterior step the list of items, which has been modified, will be decreased through two techniques, clinical impact and factorial analysis. The distribution of resulting items into dimensions will constitute the instrument whose format has been designed: Life Satisfaction, Idealized Quality of Life and Actual Quality of Life.

ASSUNTO(S)

quality of life avaliação assessment impact in health qualidade de vida impactos na saúde idoso escalas elderly

ACESSO AO ARTIGO

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