A psychosocial model of functional disability

摘要

With advancing age, many older adults are vulnerable to a decline in physical functioning. Functional disability has been shown to affect the subjective well-being of the individual, and has been associated with increased morbidity and mortality. Social support is commonly assumed to protect people from the experience of psychological distress and enhance well-being. Other studies have demonstrated that satisfaction with social support, rather than the frequency with which support was received, is a powerful predictor of self-reported health status. The present study tests a psychosocial model of functional disability in two elderly populations (61 years of age and older): 178 seniors living in the community (136 females and 42 males) and 168 in-patients in a rehabilitation hospital following total hip and knee arthroplasty (118 females and 50 males). Predictors of functional disability were age, gender, and satisfaction with support. In this model, functional disability, with its related loss of independent functioning, was expected to lead to depression. Results indicated that the two samples differed slightly. Specifically, the elderly in the community sample were significantly older than the rehabilitation patients, whereas the hospital sample reported greater functional disability and were more satisfied with their social relations than the community-residing elderly. Results of path analysis in both samples showed that women reported more functional disability than men and satisfaction with support was associated with lower functional disability. Furthermore, functional disability led directly to depression in both samples. Practical implications for the maintenance and enhancement of daily functioning, as well as well-being in later life are discussed.