[Spirituality in old age as dynamic aging task]. / Spiritualität im höheren Lebensalter als dynamische Alter(n)saufgabe.

BACKGROUND: A multitude of studies have demonstrated a positive effect of spirituality for dealing with difficult situations in life; however, specific studies on spirituality in older age are exceptionally rare within the German gerontological research landscape. The theory of gerotranscendence by Tornstam indicates that spirituality is of particular importance for maintaining life satisfaction especially in older age, due to a change in perspective. OBJECTIVES: This study looked into the research questions of how spirituality is presented in the oldest old (80 years and older) in Germany and to what extent its characteristics are specific to older age. MATERIAL AND METHODS: Problem-centered interviews were conducted with 20 oldest old subjects and evaluated using qualitative content analysis. RESULTS: Spirituality in itself is not specific to very old age. Its shaping, however, as an existential process of transformation and redefinition, is specific in the oldest old due to their socialization and biographical experiences over the life course impregnated by processes of subjectification and individualization. In addition, its relation to existential questions gains increasing relevance and priority in very old age in an affective, reflective and performative dimension, and the answers change between fragility and continuity. CONCLUSION: As a heterogeneous (intermediate) result of experiences over the life course against the background of socialization and individual existential interpretation of "Self" and "World", spirituality in the oldest old should be perceived in this diverse and dynamic manner in research and practice, in order to foster well-being in old age.

Quality of life of the very old : Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+).

BACKGROUND: In Germany, the very old are the most rapidly growing proportion of the population. A comprehensive investigation of the conditions for a good quality of life in this group is relevant for both society and politics. OBJECTIVE: The project "Quality of life and subjective well-being of the very old in North Rhine-Westphalia" (NRW80+) at the University of Cologne surveys quality of life of the very old. Taking into account many specific methodological and theoretical challenges, it aims at setting up a specific theoretical framework and methodological approach. METHODS: Existing studies on quality of life in old age in Germany and abroad as well as models on quality of life are reviewed with respect to their relevance for the very old and their specific living conditions, needs and interests. A theoretical framework of quality of life in very old age is developed. The NRW80+ study combines three levels: the empirical level of description of life situations and conditions, the explanative level of evaluating models of quality of life and the normative level of societal and ethical standards and norms. RESULTS: Considering results of recently conducted studies with the very old, an integrative conceptual model for studying quality of life of very old persons is introduced. In the model of challenges and potentials (CHAPO), environmental and individual factors as well as life chances and life results are thereby taken into consideration from a subjective as well as an objective point of view, supplemented by the concept of successful life conduct. CONCLUSION: Starting from the CHAPO model of quality of life, the representative study NRW80+ aims at challenging methodological standards for the inclusion of the very old in social research thus providing the basis for further research as well as for sustainable social politics especially for the very old.

Development of a Multidimensional Assessment Tool for the Evaluation of Holistic Quality of Life in Parkinson's Disease.

BACKGROUND: Parkinsonian syndromes are heterogeneous chronic neurodegenerative disorders associated with both motor and non-motor symptoms. The symptoms have major psychosocial effects on the quality of life of patients and can be a burden for caregivers. So far, several questionnaires have been developed to assess quality of life in Parkinsonism, but none of these include the positive sides on well-being such as personal and social resilience factors. OBJECTIVE: The aim of this study is to develop a digital framework for a longitudinal assessment of quality of life during the progression of Parkinson's disease. METHODS: The CHAPO model (Challenges and Potentials) has been established in a vast study by Wagner et al. to assess the quality of life of older people. This model includes environmental and individual factors, life chances, and life results, such as individual life evaluation, from a subjective as well as an objective point of view. Therefore, it has been adapted in several development steps to include the specific aspects that affect quality of life in Parkinsonian syndromes. The development process included 6 steps: definition, refinement, operationalization, piloting/debriefing, adjustment, and integration. RESULTS: The development of the CHAPO-PD model has been completed and it represents the first main result of this study. CONCLUSION: By taking a holistic understanding of quality of life into account, we expect to detect previously unrecognized factors, which correlate to the subjective well-being of Parkinson's disease patients, and aim to use these findings to improve the health care structures for patients with Parkinson's disease and related disorders.

Attitudes towards Risk Prediction in a Help Seeking Population of Early Detection Centers for Mental Disorders-A Qualitative Approach.

Big Data approaches raise hope for a paradigm shift towards illness prevention, while others are concerned about discrimination resulting from these approaches. This will become particularly important for people with mental disorders, as research on medical risk profiles and early detection progresses rapidly. This study aimed to explore views and attitudes towards risk prediction in people who, for the first time, sought help at one of three early detection centers for mental disorders in Germany (Cologne, Munich, Dresden). A total of 269 help-seekers answered an open-ended question on the potential use of risk prediction. Attitudes towards risk prediction and motives for its approval or rejection were categorized inductively and analyzed using qualitative content analysis. The anticipated impact on self-determination was a driving decision component, regardless of whether a person would decide for or against risk prediction. Results revealed diverse, sometimes contrasting, motives for both approval and rejection (e.g., the desire to control of one's life as a reason for and against risk prediction). Knowledge about a higher risk as a potential psychological burden was one of the major reasons against risk prediction. The decision to make use of risk prediction is expected to have far-reaching effects on the quality of life and self-perception of potential users. Healthcare providers should empower those seeking help by carefully considering individual expectations and perceptions of risk prediction.