Socio-demographics, spirituality, and quality of life among community-dwelling and institutionalized older adults: A structural equation model

Purpose: The increasing life expectancy of the population prompts an array of health conditions that impair an older adults' quality of life (QoL). Although demographics and spirituality have been associated with QoL, limited literature elucidated the exact mechanisms of their interactions, especially in a culturally-diverse country like Philippines. Hence, this study determined the relationship among socio-demographics, spirituality, and QoL of Filipino older adults in a community and institutional setting. Materials and methods: A predictive-correlational study among 200 randomly-selected community-dwelling and institutionalized older adults was conducted, with a 99% power and a medium effect size. Data were collected using a three-part questionnaire from September to November 2015. The questionnaire was composed of the robotfoto, Spirituality Assessment Scale, and modified Older People's Quality of Life which assessed socio-demographics, spirituality, and QoL. Results: Analysis showed that institutionalization in a nursing home positively and negatively affected spirituality and QoL, generating an acceptable model (chi(2)/df = 2.12, RMSEA = 0.08, and CFI = 0.95). The negative direct effect of institutionalization on social relationship, leisure, & social activities QoL (beta=-0.42, p < 0.01) also initiates a cascade of indirect negative effects on both spirituality and QoL dimensions. Conclusions: The development of a structural model illustrating the interrelationship of socio-demographics, spirituality, and QoL helps healthcare professionals in predicting facets of spirituality and QoL that can be compromised by living in a nursing home. This understanding provides impetus in evaluating and refining geriatric healthcare programs, policies, and protocols to render individualized, holistic care in a socially-cohesive environment among older adults. (C) 2016 Elsevier Ireland Ltd. All rights reserved.