Gender differences in psychosocial determinants of self-perceived health among Portuguese older adults in nursing homes

ABSTRACT

Objectives: Self-perceived health declines with age, varies by gender and is a predictor of mortality, morbidity, physical and psychological functioning. However, gender differences in health and illness perception are complex and not yet fully understood. This study aimed to explore gender-related differences in psychosocial determinants of self-perceived health among older adults living in nursing homes.

Method: Nationwide face-to-face survey of the Portuguese population aged 65 and over. A representative sample of nursing homes residents was obtained through a multistage cluster random sampling of nursing homes, stratified by main Portuguese administrative regions (NUTS II).

Results: Overall, 1186 nursing homes residents voluntarily enrolled in this study (participation rate, 93%) and a total of 515 participants (70.1% women) were considered to have adequate cognitive functioning to answer all questionnaires. A significant association between self-rated health and gender was found: 90.6% of all women (95% CI: 85.7—93.9) and 82.3% of all men (95% CI: 72.9—88.9) rated their health as less than good (p = 0.023). Gender-stratified analyses showed differences in psychosocial determinants of self-perceived health. While symptoms of depression and loneliness feelings were the major psychosocial determinants of poor self-perceived health among women, age and subjective financial well-being were the only determinants among men.

Conclusion: Factors associated with perceived health, as representative of healthy ageing, were identified by gender, leading to future avenues for fruitful investigation. The acknowledgement of interpersonal and socioeconomic factors that determine the experience of ageing at a national level is crucial to improve the health of elders.

KEYWORDS:

• Gender
• subjective health
• social determinants of health
• ageing
• nursing homes

Acknowledgments

The authors acknowledge the Instituto da Segurança Social, I.P. for providing the list of all Portuguese nursing homes, and Faculdade de Medicina, Universidade de Lisboa staff for the administrative support. The authors acknowledge the IAN-AF team for their support with the development of data collection software. The authors also acknowledge the interviewers who collected the data among nursing home residents, managers and administrations of the participating nursing homes, and all participants.

Disclosure statement

The authors declare that there are no conflicts of interest.

Additional information

Funding

The present project (136SI5) was granted by the Public Health Initiatives Programme (PT06), financed by EEA Grants Financial Mechanism 2009-2014.