Relationship of quality of life to dispositional optimism, health locus of control and self-efficacy in older subjects living in different environments.

PURPOSE: To describe the relationship of dispositional optimism, health locus of control and self-efficacy to quality of life (QOL) in older subjects differing in level of disability and institutionalisation.
METHODS: The study was conducted in the three groups of subjects aged > or = 65: 110 relatively healthy community-dwelling elderly, 102 independent elders who voluntarily decided to live in veteran home and 112 inhabitants of a long-term care home. Life orientation test-revised (LOT-R), multidimensional health locus of control (MHLC) and generalised self-efficacy scale (GSES) together with a multidimensional assessment were performed with each subject. QOL was assessed using the Euroqol 5D questionnaire, the Nottingham health profile and the satisfaction with life scale (SWLS).
RESULTS: QOL generally decreased with growing level of dependence and institutionalisation. LOT-R, MHLC and GSES were important and independent correlates of QOL in all three environments of older subjects. The relationship of education, smoking habit, physical activity, strength and mobility measures to psychological characteristics was different in the three groups of elders. LOT-R, MHLC Powerful Others, MHLC Chance and GSES were the most important QOL correlates in veteran home group, while MHLC Internal was most significant in long-term care home inhabitants.
CONCLUSIONS: Data of this cross-sectional study suggests that the veteran home elderly, as a group 'in transition' between community and institution, should be the first target of psychological preventive and health-promoting measures aimed at improving QOL in older population.