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Item Social network type contributes to purpose in life among older people, mediated by social support.(Springer Nature, 2024-01-17) Bakhshandeh Bavarsad M; Stephens C; Glaser KA sense of Purpose in Life is an important aspect of ageing well which is related to older adult's social relationships. Social network types and the different sources of support they provide are theorized here as a pathway to maintaining a sense of purpose as we age. The study utilized a population sample from the 2016 and 2020 NZ Health, Work, and Retirement (NZHWR) longitudinal survey waves; N = 2869 (mean age of 65.82 years (SD = 6.40). A structural equation model investigated the relationship between Social Network Type and Purpose in Life and the mediating role of Social Support. The final model had a good fit to the data and explained 33.7% of the variance in Purpose in Life. Private, Self-Contained and Family Dependent network types (2016) were negatively related to Purpose in Life 4 years later (2020). Support from sense of Attachment, Reassurance of Worth, Reliable Alliance and Social Integration played a mediating role between Social Network type and Purpose in Life. These findings highlight the importance of social networks in maintaining a sense of purpose among older adults and highlight pathways for the types of networks, and kinds of social support they offer, which contribute to a sense of purpose in life. They underscore the importance of social support for the well-being of older adults and highlight the need to consider the quality and type of social networks and support they provide, when designing interventions to enhance well-being.Item Mild cognitive impairment and quality of life in the oldest old: a closer look(Springer Nature Switzerland AG, 2020-06) Hussenoeder FS; Conrad I; Roehr S; Fuchs A; Pentzek M; Bickel H; Moesch E; Weyerer S; Werle J; Wiese B; Mamone S; Brettschneider C; Heser K; Kleineidam L; Kaduszkiewicz H; Eisele M; Maier W; Wagner M; Scherer M; König H-H; Riedel-Heller SGPurpose Mild cognitive impairment (MCI) is a widespread phenomenon, especially affecting older individuals. We will analyze in how far MCI affects different facets of quality of life (QOL). Methods We used a sample of 903 participants (110 with MCI) from the fifth follow-up of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe), a prospective longitudinal study, to analyze the effects of MCI on different facets of the WHOQOL-OLD. We controlled for age, gender, marital status, education, living situation, daily living skills, and the ability to walk, see, and hear. Results Univariate analyses showed that individuals with MCI exhibited lower QOL with regard to the facets autonomy; past, present, and future activities; social participation; and intimacy, but less fears related to death and dying. No significant difference was shown with regard to the facet sensory abilities. In multivariate analyses controlling for age, gender, marital status, education, living situation, daily living skills, and the ability to walk, see and hear, MCI-status was significantly associated with QOL in the facet autonomy. Conclusion Effects of MCI go beyond cognition and significantly impact the lives of those affected. Further research and practice will benefit from utilizing specific facets of QOL rather than a total score.Item Enablers and barriers to prevent weight-regain post bariatric surgery - A qualitative enquiry(Elsevier Ltd, 2022-12) Billing-Bullen G; Nielsen D; Wham C; Kruger RBackground Weight-regain is commonly experienced after bariatric surgery. This qualitative enquiry aimed to explore participants' self-reported enablers and barriers to prevent future weight-regain post-surgery. Methods Eligible adults were recruited at 12-months post-bariatric-surgery at Counties Manukau, Auckland. Participants were invited to attend data collection at their 18-month group nutrition-education session, and to participate in a focus group at 21-months post-surgery. Thematic analysis was used to evaluate patient experiences. Results Participants (n = 28) were mostly female (73.2 %), New Zealand European (41.5 %), and had gastric sleeve surgery (92.3 %). Five key themes emerged from the analysis: A Life Changing Health Journey - participants experienced a decrease in obesity-related comorbidities and a subsequent decrease in medications. Weight change and food intolerances impacted quality of life. Challenge of managing a New Healthy Lifestyle - financial stress, buying healthier foods and social events were new challenges, often centred on food. Changing Eating Behavior - all participants struggled managing eating behaviors. Mindset Changes - post-surgery most participants had a positive mindset, increased confidence, and feelings of happiness. However, many struggled with mindset around weight and food. A need for On-going Support - most felt under-supported and expressed a need for longer, specific follow-up care. Conclusion Post-surgery group education sessions provided participants with increased support from both health professionals and peers on the same journey, to overcome struggles such as binge eating or identifying new coping strategies. Findings provide important insights into the challenges patients with bariatric surgery face and key learnings to develop specific supports for future care practices.Item A shared revelation : a comparative, triangulated study on improving quality of life in the terminally ill : a thesis submitted in partial fulfilment of the requirements for the degree of Master of Arts in Nursing, Massey University(Massey University, 2001) Hill, NitaThis thesis examines the concept and measurement of quality of life (QOL) in the terminally ill and how this QOL can be improved within a hospice setting. Three threads are examined to help come to an understanding of how an improvement in QOL for the terminally ill can be achieved. These threads are: what effect present hospice care has on patients' QOL; how effective nurses are at understanding the patients' perspective of that QOL; and, whether nurses could contribute to an improvement in that QOL. Seventy two patients and ten nurses participated in this comparative, triangulated research project. A control and intervention group of patients enabled comparison of the effects of an intervention (joint care planning by patient and nurse based on the patient's QOL assessment results) on patients' QOL. In the quantitative aspect of the study, a QOL questionnaire was used, by patients and nurses, to provide objective data. This quantitative data was illuminated and extended by qualitative methods namely, formal and informal interviews, written comments, field observations, and a nursing focus group. The findings of the study reveal that a better understanding of the patient can be achieved if nurses have access to the patient's QOL perspective. This better understanding, when translated into meeting patients' QOL priorities and needs, results in clinically significant improvements in their QOL. Reflective practice in nurses, promoted by exposure to differences in patient/nurse perspectives, was demonstrated. Reflective practice resulted in behavioural changes in the participating nurses, increasing their awareness of QOL issues for subsequent patients and influencing their on-going palliative care. The theme of 'revelation' encapsulates the insights gained from the research process for patients, nurses, and the researcher. Such revelation was personal and, in some cases, life-changing for the patients, and involved both personal and professional dimensions for the others. The study concludes by suggesting ways in which revelation can be sustained in the hospice setting. The recommendations cover personal, professional, and organisational dimensions. If implemented, the recommended changes would enhance patients' QOL through the continuing development of advanced palliative care nursing skills. The early pioneering philosopy of palliative care would thus be perpetuated in the development of new ways of caring. Palliative care could then confidently continue to demonstrate its unique place within the health services.Item Social indicators and geographic research : an exploratory study of spatial variations in the provision of community services and accommodation for elderly people in New Zealand : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in geography at Massey University(Massey University, 1974) Britton, Stephen GrahamSocial Research and Social Learning: The operation of the welfare state system in New Zealand has undoubtedly shaped the national character and influenced at least implicitly, national socio-economic values.1 "A Welfare State is a state in which organised power is deliberately used (through politics and administration) in an effort to modify the play of market forces in at least three directions - first by guaranteeing individuals and families a minimum income irrespective of the market value of their property : secondly by narrowing the extent of insecurity by enabling individuals to meet certain "social contingencies" (for example: sickness, old age and unemployment) which lead otherwise to individual and family crises: and thirdly, by ensuring that all citizens without distinction of status or class are offered the best standard available in relation to a certain agreed range of social services". (Briggs : In Jones 1973 : 65). While several writers have documented the tangible benefits this system has offered to the nation as a whole and various social groups in particular (Baker 1955, Condliffe 1959, Scott 1955 and Sutch 1971) the welfare state concept as practiced in New Zealand has never been geared to actually anticipate or cope with any socio-economic problem outside its limited frame of application. While the Welfare State system originated in the depression era and gained strength into the 1950's, social demands today are increasingly less concerned with what Dunn (1971 : 183) has termed "deficit motives". What is now more worthy of consideration is a system of social organisation and administration that meets the human development motives of an affluent and dynamic society - demands that are not usually considered in the realm of national and political decision making. The need for a shift in the socio-political responsibilities of government was officially recognised in New Zealand at the 1969 National Development Conference, (N. D. C.). The various N. D. C. bodies identified vague and general areas of social concern outside of those issues confronted by the Welfare State system as being worthy of inclusion in Government responsibility. The National Development Conference also revealed to New Zealand government administrators that virtually no action was possible to remedy undesirable states, even if government was prepared to respond, simply because so little was known about the social phenomena in question, and only inadequate information was available on the existing states of New Zealand society. Moreover, there were few documented guidelines to suggest the future trends in New Zealand society and, indeed, what direction New Zealanders might prefer their society to take. New Zealand decision-makers and researchers were lacking in the fundamental tools for planning current and future states and coping with dysfunctions in many social fields. Data deficiencies are further exacerbated by the absence of any background of social inquiry outside of the economic sphere of national and social planning.Item An evaluation of Qol-Steps : idiographic assessment of quality of life for patients in palliative care : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 1999) Jardine, AndrewThe primary objective of this study was to evaluate an assessment tool that would enable patients in palliative care to communicate their individual quality of life(QoL) concerns. An examination of existing QoL assessment instruments suggested that most were based upon assumptions more appropriate for research on groups of patients. Such assessment can be classified as standard needs measures. While useful for comparing patients at the aggregate level, standard needs approaches to assessing QoL may not be useful in clinical situations. Instead, an idiographic approach to the assessment of QoL was adopted and it is the development of a particular instrument, called QoL-Steps, which forms the basis for this study. QoL-Steps used a graphical procedure that enabled patients to nominate their important personal aspects of quality of life, rank these aspects in order of importance, and rate the current and ideal levels of each aspect in two different time periods. The data from a sample of 42 out-patients of a hospice programme, highlighted the variability that would be expected from an idiographic approach to the assessment of individual patients. Results from Qol-Steps suggest that the instrument is a viable tool. QoL-Steps provided a wide range of variability for patients, in terms of content, difference scores, rankings and patterns of change. Importantly, many patients saw QoL-Steps as a means of communicating their unique needs within an individual context.Item The relationship between standard of living and quality of life for older New Zealanders : a thesis presented in partial fulfilment of the requirements for the degree of Master of Science in Psychology at Massey University, Wellington, New Zealand(Massey University, 2015) Graham, Stewart EdwinThe well-being of older people is an increasingly important issue. This is due to both the increasing proportion of older people in the population and rising levels of inequality in New Zealand. What well-being is and what influences well-being is an important question when considering the welfare of older people. Standard of living and quality of life offer two different ways of understanding well-being. It is vital to understand the impact that changing standard of living has on older people’s quality of life. The aim of this study was to explore the relationship between standard of living and quality of life and consider the impact of other factors on quality of life for older people in New Zealand. This study is a secondary analysis of data from the 2012 wave of the New Zealand Longitudinal Study of Ageing. This study includes 2984 people aged between 50 and 87 years of age. Bivariate and hierarchical multiple regression analysis was employed to explore the relationship between standard of living, quality of life, health-related variables (physical health, mental health, depression, mobility and loneliness) and demographic variables. Results revealed two main findings. Firstly, that a low standard of living does not preclude a high quality of life, but a high standard of living means a low quality of life is less likely. Secondly, the relationship between standard of living and quality of life is mediated by health-related variables. Psychological health-related variables (mental health, depression and loneliness) mediated the relationship more than physical health-related variables (physical health and mobility). These demonstrate that although a high standard of living is not a prerequisite for a high quality of life, it can potentially provide a buffer against factors which cause poor quality of life such as poor physical and mental health. Increases in standard of living for older people can therefore act to mitigate key factors contributing to poor quality of life. These findings have important implications for future policy development in relation to the welfare of older New Zealanders.Item The quality of life, risk of abuse, and self-esteem of older adults in the Manawatu : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosophy in Psychology at Massey University(Massey University, 1997) McDonald-Smith, Patricia BridgetThe aim of this study was to explore and investigate levels of quality of life, levels of self-esteem and risk for abuse in elderly New Zealanders, either living the community or in rest homes. Subjects were 50 individuals, aged 64 to 99 years, half of which were drawn by random sample from either private dwellings and city council accommodation in the community, or by convenience sample from the Royal New Zealand Foundation for the Blind. The other half was drawn by convenience sample from seven preselected rest homes in the region. Each subject was individually and personally interviewed by the researcher, and measures of quality of life using Cummins' Comprehensive Quality of Life questionnaire (ComQol-4; Cummins, 1993), of self-esteem using the Rosenberg Self-esteem Scale (Bachman, O'Malley & Johnston, 1978), and of risk for abuse using the Hwalek-Sengstock Elder Abuse Screening Test H/S-EAST (Neale, Hwalek, Scott, Sengstock & Stahl, 1991) were administered. Analysis of the results revealed that quality of life of Manawatu elders was found to be at a medium level. Satisfaction with quality of life was similar to Australian older adults, and elders were satisfied with all life areas studied, being most satisfied with interpersonal relationships and least satisfied with health. The level of self-esteem of elders was found to be low. The overall level of risk for abuse was found to be less than levels in overseas abused and comparison groups. Elderly persons living in the community had better objective quality of life than those living in rest homes. However, there were no differences between these two groups on perceived satisfaction with and importance of the various areas or domains contributing to quality of life, on self-esteem, or on risk for abuse. Implications of the results, methodological issues and future directions for New Zealand research were discussed.Item The role of self-efficacy in perceived quality of life in people with both insulin-dependent and non-insulin dependent diabetes : a thesis presented in fulfilment of the requirements for the degree of Master of Arts in Psychology at Massey University(Massey University, 1995) Parry, Nerys CeridwenDiabetes Mellitus is an illness that affects more than 100,000 people in New Zealand. This study examined the variables which were thought to be most likely to impact on the quality of life of people with either Insulin Dependent Diabetes Mellitus (IDDM) or Non-Insulin Dependent Diabetes Mellitus (NIDDM). Diabetes requires a high degree of self-management on a daily basis. The challenges for people with diabetes are to maintain a healthy level of blood glucose by carrying out adequate self-care behaviours. It was thought these may represent barriers to unrestricted quality of life, and the study investigated the degree to which cognitive-affective processes were diverted into self-care and illness appraisal. The two groups were studied to investigate which psychological factors would influence perceptions of wellbeing, and whether or not the psychological areas of significance were correlated with blood glucose levels (HbA1C), depicting good metabolic control. Using a questionnaire survey method, this study examined the psychological processes of 99 people with diabetes (36 IDDMs and 63 NIDDMs), assessing in particular, their self-efficacy, perception of risk, and psychological control, all considered to be factors that would be likely to affect their quality of life. Measures used included illness appraisal, wellbeing and self-efficacy scales, as well as a small qualitative section eliciting personal comments. The findings indicated a moderate level of self-efficacy and wellbeing across the sample which was adversely affected when they were compelled to take barriers to effective self-care into account. Risk perception was considered to be inadequate, especially when correlated with other factors, suggesting that self-efficacy was maintained by sidelining the risks or threats of diabetes. On the whole, the sample were particularly effective at maintaining adequate weight through diet, and a significant proportion were not taking any medication at all. Severe hypoglycaemic episodes were rare. Perception of control was another issue which appeared to be adequate for the sample, but it was found that people's perceived control was a more cogent variable than actual metabolic control (as measured by HbA1C assay). It was possible to infer stages of self-efficacy according to the manner in which people responded. Drawing on self-efficacy measures found to be effective in assessing populations with chronic conditions, it was found that there was some support for the notion that resistance self-efficacy and coping self-efficacy were the mechanisms at work for these people. Comments from respondents showed a desire for more information and better public awareness of diabetes, and offered some insight into the mechanisms by which people maintain an adequate quality of life despite chronic illness.Item 'This is my ideal life' : the importance of place for how Māori elders understand a good life : a thesis presented in partial fulfillment of the requirements for the degree of Master of Arts in Psychology at Massey University, Palmerston North, New Zealand(Massey University, 2012) Butcher, Elizabeth AnahAttachment to place is considered to be an important component of ageing and can be intertwined with an older persons identity. For this reason place cannot be separated from understandings of a good life. This study examined the ways that elder Maori living on the East Cape construct a good life and how place may influence this understanding. Data analysis involved eight interviews with older Maori and a research visit to the East Cape. The thesis used a mixed methods approach to qualitative analysis combining Interpretative Phenomenological Analysis with Foucauldian Discourse Analysis. Principles of Kaupapa Maori research were also integrated throughout the research process. Four superordinate themes of ageing well, social connectedness, economic wellbeing, and autonomy and control were identified as contributing to the experience of a good life. The four superordinate themes represent different components that must be negotiated in order to balance these demands. The analysis also identified a number of discourses including positive ageing discourse, anti-consumption discourse, family discourse and neo-liberal discourse. These discourses were drawn on to balance competing expectations regarding a good life and present the participants identities in a morally virtuous manner. This analysis demonstrates how a good life depends upon finding a balance between the competing demands of living within the wider society, attachment to place, and Maori identity in later life.