Quality of life in old age - a concept analysis.

AIM: To identify existing definitions of quality of life in old age and to determine the most suitable for evaluating outcomes of nursing care for older adults.
BACKGROUND: Promoting quality of life is a central concern of nursing care for older persons. There is, however, a lack of clarity about the meaning of this concept. Attributes of quality of life are often confused with those factors influencing them.
DESIGN: Concept analysis according to Walker and Avant.
METHOD: A search was carried out in the databases MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO(®) and Gerolit for the years 1992-2013. Excerpts dealing with definitions, antecedents, consequences and empirical referents of the concept were compiled.
RESULTS: Three basic concepts for quality of life were identified: satisfying life conditions, subjective general well-being and subjective fulfilment of dimensions of human life. DISCUSSION: Satisfying life conditions are antecedent to the other concepts. It is not suitable to view such conditions as an outcome of nursing care for older adults because an outcome has to be a consequence. General well-being is likely to remain stable over time and changing conditions due to adaptation taking place. Fulfilment of dimensions of human life as a multidimensional inner state may be more sensitive to changing conditions.
CONCLUSION: Fulfilment of dimensions of human life is the most suitable definition of quality of life in old age as an outcome of nursing care. Studies are needed to decide whether it is responsive to changing circumstances. IMPLICATIONS FOR PRACTICE: Fulfilment of dimensions of human life should be assessed to provide care that meets the needs of clients.