Psychological and physical wellness in older adults from the patient perspective


The authors of this study examined the relationship between life attitude and physical disease state and found that psychological well being mediated patients’ illness course. Coherence and life control were endorsed as the important components of psychological well being. A multi-dimensional measure of life purpose was administered to 97 older adults on the acute rehabilitation unit of a major medical center in the United States. The severity of their illness burden was computed blindly by a physician rater. Regression analysis was conducted to determine if life attitude was predictive of the symptom ratings and factor analysis was performed on the individual items of the life attitude instrument to highlight the psychological profile of the older adults in this study for whom health challenges were primary. There was a significant relationship between life attitude and disease severity, even though the fit of the model indicated the need for other explanatory factors to fully account for sickness. Factor analysis demonstrated that items defined as measuring coherence and life control explained the largest proportion of total variance. Coherence incorporated the logical integration and consistent understanding of one’s self and the world at large. Life control referred to volition in decision making, exercising of personal responsibility, and the unfolding of life events. The findings suggested that in older adults undergoing medical hospitalization, psychological resilience had a retrospective orientation rather than prospective. The significant influence of life attitude on patients’ physical condition was consistent with clinical observations that the patients who resiliently endure health challenges seem to possess a hardy psychological reserve.

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Song, S. , Prerost, F. , Gonzalez, E. and Woodin, J. (2012) Psychological and physical wellness in older adults from the patient perspective. Health, 4, 80-87. doi: 10.4236/health.2012.42013.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Selye, H. (1946) The general adaptation syndrome and the diseases of adaptation. Journal of Clinical Endocrinology, 6, 117-230. doi:10.1210/jcem-6-2-117
[2] Solomon, G.F. and Moos, R.H. (1964) Emotions, immunity, and disease: A speculative theoretical integration. Archives of General Psychiatry, 11, 657-674. doi:10.1001/archpsyc.1964.01720300087011
[3] Christiansen, C. (2007). Adolf Meyer revisited: Connections between lifestyles, resilience and illness. Journal of Occupational Science, 14, 63-76. doi:10.1080/14427591.2007.9686586
[4] Berczi, I. (1998) The stress concept and neuroimmunoregulation in modern biology. Annals New York Academy of Sciences, 851, 3-12. doi:10.1111/j.1749-6632.1998.tb08969.x
[5] Dockray, S. and Steptoe, A. (2010). Positive affect and psychobiological processes. Neuroscience and Biobehavioral Reviews, 35, 69-75. doi:10.1016/j.neubiorev.2010.01.006
[6] Ryff, C.D., Love, G.D., Urry, H.L., Muller, D., Rosenkranz, M.A., Friedman, E.M., Davidson, R.J. and Singer, B. (2006) Psychological well-being and ill-being: Do they have distinct or mirrored biological correlates? Psychotherapy and Psychomatics, 75, 85-95. doi:10.1159/000090892
[7] Reker, G.T. and Peacock, E.J. (1981). The life attitude profile (LAP): A multidimensional instrument for assessing attitudes toward life. Canadian Journal of Behavioral Science, 13, 264-273. doi:10.1037/h0081178
[8] World Health Organization (1967) Health promotion glossary. Constitution of the World Health Organization, Geneva.
[9] Roscoe, L.J. (2009) Wellness: A review of theory and measurement of counselors. Journal of Counseling & Development, 87, 216-226. doi:10.1002/j.1556-6678.2009.tb00570.x
[10] Maddi, S.R. (2005) On hardiness and other pathways to resilience. American Psychologist, 60, 261-262. doi:10.1037/0003-066X.60.3.261
[11] Fisher, J.W., Francis, L.J. and Johnson, P. (2000) Assessing spiritual health via four domains of spiritual wellbeing: The SH4DI. Pastoral Psychology, 49, 133-145. doi:10.1023/A:1004609227002
[12] Sperry, L. (1992) Recent developments in neuroscience, behavioral medicine, and psychoneuroommunology: Implications for physical and psychological well-being. Individual Psychology, 48, 480-487.
[13] Cowen, E.L. (1991) In pursuit of wellness. American Psychologist, 46, 404-408. doi:10.1037/0003-066X.46.4.404
[14] Ryff, C.D. and Keyes, C.L.M. (1995) The structure of psychological well-being revisited. Journal of Personality and Social Psychology, 69, 719-727. doi:10.1037/0022-3514.69.4.719
[15] Mirowsky, J. and Ross, C. (2010) Well being across the life course. In: Horwitz, A.V., Ed., A Handbook for the Study of Mental Health: Social Contexts, Theories, and Systems, Cambridge University Press, New Brunswick, 361-383.
[16] Yorkston, K.M., McMullan, K.A., Molton, I. and Jensen, M.P. (2010) Pathways of change experienced by people aging with disability: A focus group study. Disability and Rehabilitation, 32, 1697-1704. doi:10.3109/09638281003678317
[17] Frankl, V.E. (1963) Man’s search for meaning. Washington Square Press, New York.
[18] Nygren, B., Aléx, L., Jonsén, E., Gustafson, Y., Norberg, A. and Lundman, B. (2005) Resilience, a sense of coherence, purpose in life and self-transcendence in relation to perceived physical and mental health among the oldest old. Aging & Mental Health, 9, 354-362. doi:10.1080/1360500114415
[19] Siegel, B.S. (1990) Love, medicine and miracle: Lessons learned about self-healing from a surgeon’s experience with exceptional patients. Harper Collins Publishers Inc., New York.
[20] Hafen, B.Q., Karren, K.J., Frandsen, K.J. and Smith, N.L. (1996) Mind/body health: The effects of attitudes, emotions, and relationships. Allyn & Bacon Publishers Inc., Needham Heights.
[21] Crumbaugh, J.C. and Maholich, L.T. (1969) An experimental study in existentialism: The psychometric approach to Frankl’s concepts. Journal of Clinical Psychology, 20, 200-207. doi:10.1002/1097-4679(196404)20:2<200::AID-JCLP2270200203>3.0.CO;2-U
[22] Antonovsky, A. (1993) The structure and properties of the sense of coherence scale. Social Science & Medicine, 36, 725-733. doi:10.1016/0277-9536(93)90033-Z
[23] Reed, P.G. (1991) Self-transcendence and mental health in oldest-old adults. Nursing Research, 40, 5-11. doi:10.1097/00006199-199101000-00002
[24] Erikson, E.H. (1980) Identity and the Life Cycle. W.W. Norton & Company, New York.
[25] Miller, M.D., Paradis, C.F., Houck, P.R., Mazumdar, S., Stack, J.A., Rifai, A.H., Mulsant, B. and Reynolds, C.F. (1992) Rating chronic medical illness burden in geropsychiatric practice and research: Application of the Cumulative Illness Rating Scale. Psychiatry Research, 41, 237- 248. doi:10.1016/0165-1781(92)90005-N
[26] Costello, A.B. and Osborne, J.W. (2005) Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10, 1-9.
[27] Field, A.P. (2005) Discovering Statistics Using SPSS. 2nd Edition, Sage Publications, London.
[28] Almeida, D., Seltzer, M., Greenberg, J., Savla, J., Stawski, R., Hong, J. and Taylor, J. (2009) Psychosocial and biological markers of daily lives of midlife parents of children with disabilities. Journal of Health and Social Behavior, 50, 1-15.
[29] Charles, S.T., Almeida, D.M., Neupert, S.D., Schaie, K.W. and Abeles, R.P. (2008) Assessing health behaviors across individuals, situations, and time. In: Abeles, R.P. and Schaie, K.W., Eds., Social Structures and Aging Individuals: Continuing Challenges, Springer, New York.
[30] McGonagle, K., King, H. and Almeida, D. (2009) Assessing daily stress processes in social surveys by combining stressor exposure and salivary cortisol. Biodemography and Social Biology, 55, 219-237. doi:10.1080/19485560903382338
[31] Meyer, J., Cifuentes, M.M. and Warren, N. (2011) Association of self-rated physical health and incident hypertension with O*NET factors: Validation using a representative national survey. Journal of Occupational and Environmental Medicine, 53, 139-145. doi:10.1097/JOM.0b013e318203f220
[32] Morozink, J.A., Friedman, E.M., Coe, C.L. and Ryff, C.D. (2010) Socioeconomic and psychosocial predictors of Interleukin-6 in the MIDUS national sample. Health Psychology, 29, 626-635. doi:10.1037/a0021360
[33] Piazza, J.R., Almeida, D.M., Dmitrieva, N.O. and Klein, L.C. (2010) Frontiers in the use of biomarkers of health in research on stress and aging. Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 65, 513-525. doi:10.1093/geronb/gbq049
[34] Seeman, T.E., Love, G.D., Weinstein, M. and Ryff, C.D. (2010) Bioindicators in the MIDUS national study: Protocol, measures, sample, and comparative context. Journal of Aging and Health, 22, 1059-1080. doi:10.1177/0898264310374355
[35] Seltzer, M.M., Abbeduto, L., Greenberg, J.S., Almeida, D.M., Witt, W. and Glidden, L.M. (2009) Chapter 7: Biomarkers in the study of families of children with developmental disabilities. In Seltzer, M.M. and Glidden, L.M., Eds., International Review of Research in Mental Retardation, Academic Press, New York, 213-249.
[36] Slopen, N., Lewis, T.T., Gruenewald, T.L., Mujahid, M.S., Ryff, C.D., Albert, M.A. and Williams, D.R. (2010) Early life adversity and inflammation in African Americans and Whites in the midlife in the United States survey. Psychosomatic Medicine, 42, 694-701. doi:10.1097/PSY.0b013e3181e9c16f
[37] Jones, R., Fong, T., Metzger, E., Tulebaev, S., Yang, F., Alsop, D., Marcantonio, E., Cupples, L., Gottlieb, G. and Inouye, S. (2010) Aging, brain disease, and reserve: Implications for delirium. American Journal of Geriatric Psychiatry, 18, 117-127. doi:10.1097/JGP.0b013e3181b972e8
[38] Shan, C. and Miller, M. (2003) Excess length of stay, charges, and mortality attributable to medical injuries during hospitalization. Journal of the American Medical Association, 290, 1869-1874.
[39] Kroenke, K. and Price, K. (1993) Symptoms in the community, prevalence, classification and psychiatric comorbidity. Archives of Internal Medicine, 153, 2472-2485. doi:10.1001/archinte.1993.00410210102011
[40] Kim, J., Tofade, T. and Peckman, H. (2009) Caring for the elderly in an inpatient setting: Managing insomnia and polypharmacy. Journal of Pharmacy Practice, 22, 494-506. doi:10.1177/0897190008330199
[41] Maslow, A.H. (1970) Motivation and Personality. 3rd Edition, Harper & Row, New York.
[42] United States Census Bureau (2008) Decennial Census Projections [Summary tables]. tables.html
[43] Daniel, J.H., Roysicar, G., Abeles, N. and Boyd, C. (2004) Individual and cultural diversity competency: Focus on the therapist. Journal of Clinical Psychology, 60, 755-770. doi:10.1002/jclp.20014

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