[Evaluation of life in the elderly (LWO): the validation of a measuring instrument]. / Levenswaardering bij ouderen (LWO): de validering van een meetinstrument.

The goal of this study is the adaptation and validation of the Dutch translation of Lawton's "Valuation of Life" scale. In developing this scale Lawton et al. argued that the usual health related quality of life scales had a limited contribution in explaining health utility and desired length of life and that the "Valuation of Life" is intended to cover a specific quality of life domain not related to health. The translated scale has been implemented in the 4th observation of the Longitudinal Aging Study Amsterdam (LASA) in 2001-2002. In total 1139 respondents between 65 and 95 years old reacted to the written questionnaire. After extensive structural analyses of the data we concluded that the Dutch version of the scale could be reduced from the original 19-item to a 12-item scale. In addition this scale could be divided in three 4-items-subscales, clearly labelled as Resilience, Ambition and Vitality. The new scale as well as the subscales hardly overlap with the data of two health related quality of life scales while the overlap with the more or less objective health measures (discriminant validity) remains limited. It appears that the Dutch "Valuation of Life" scale is to a certain extend related to other positive affect measures as Self evaluation, Mastery and Self-efficiency (concurrent validity). For the moment we agree that the Dutch scale measures an important and specific domain of quality of life without any reference to health issues in the scale. Whether these data contribute in explaining health utility and desired length of life remains to be demonstrated in another publication.

Escape loneliness by going digital: a quantitative and qualitative evaluation of a Dutch experiment in using ECT to overcome loneliness among older adults.

BACKGROUND: This study evaluates the outcomes of an Internet-at-home intervention experiment that intended to decrease loneliness among chronically ill and physically handicapped older adults through introducing them to the use of an electronic communication facility. METHOD: To determine the effectiveness of the experiment in terms of reducing loneliness, 15 older adults were interviewed three times: shortly before the start, two years later and immediately after termination of the experiment, while their loneliness scores at zero and post-measurement were compared with those of a control group. RESULTS: Both the participants and the control persons experienced a reduction in loneliness over time. However, the reduction was only significant for the intervention participants. Moreover, the changes in loneliness were significantly greater among the participants compared to the control persons. When looking more in detail, the effect of the experiment was only significant regarding emotional loneliness and among the highest educated. Findings of the qualitative research enabled us to understand the mechanisms through which the intervention helped alleviate loneliness. E-mail was found to facilitate social contact. Furthermore, the computer and Internet were often used to pass the time, taking people's minds off their loneliness. Unexpectedly, the intervention also improved people's self-confidence. CONCLUSION: The decline in loneliness is likely to be greater if persons under more favorable circumstances are selected and if more social functions of the Internet are used.

[Effect of changes in physical capacities upon personal social network in aging people]. / Gevolgen van veranderingen in fysiek functioneren voor het persoonlijk relatienetwerk bij het ouder worden.

The aim of the research is to assess whether there is change in the size and composition of older adults' personal network. Furthermore, change in contact frequency and received instrumental support within the relationships is studied. Five relationship types are distinguished: children, other kin, friends, neighbors and acquaintances. Older adults with a decline in physical capacity are compared with those with stable and increased capacities. Furthermore, differences according to (change in) partner status and age are investigated. Data are from the Longitudinal Aging Study Amsterdam, including the first and fourth observation of 1634 older adults living independently. The observation interval is 7 years. A decline in physical capacities is observed for 35% of the older adults, the capacities are stable for 60% and an increase is observed for 5% of the respondents. In general, network size and composition did not change. The frequency of contact within the relationships decreased. Decline was considerable for parent-child relationships, but relatively modest among older adults who faced a moderate to strong physical decline. However, among older adults who did not have a partner at the fourth observation and among the oldest (> 75 years) the frequency of contact with children increased, independently of the degree of physical decline. The decline in contact with neighbours was nearly absent for older adults who faced a moderate to strong physical decline; the contact increased when there was no partner at the fourth observation. The instrumental support received increased within all relationship types, independently of the degree of physical decline. It is concluded that research into determinants of the decline and increase in parent-child contacts is needed and that the meaning of neighbours should receive attention.

Religious climate and geographical distribution of depressive symptoms in older Dutch citizens.

This study examines whether the degree of conservatism of the religious climate affects the geographical distribution of late life depressive symptoms. A U-shaped relationship is hypothesized: high levels of depressive symptoms at the extremes (both a-religious and hyperconservative), and a low level in the middle (moderate-conservative). Subjects are 3051 older Dutch citizens (55-85 years), living in 11 municipalities. Depressive symptoms are assessed using the CES-D. Religious climate is estimated on the municipality level, using percentages votes on political parties with a Christian background (moderate-conservative versus hyperconservative). Using multi-level analysis, the results support the U-curve hypothesis.

Psychological distress in victims of elder mistreatment: the effects of social support and coping.

The objective of the study was to examine psychological distress in victims of elder mistreatment and to determine whether social support, coping style, mastery, and perceived self-efficacy favorably influence the psychological health of these victims. The study sample consisted of 77 subjects who reported recent chronic verbal aggression, physical aggression, or financial mistreatment, and a control group of 147 subjects who had not been mistreated. All participants were elderly persons who were over 65 years of age and living independently in the community. Social support, coping style, mastery, and perceived self-efficacy were measured by means of a standardized home interview. Psychological distress was measured by means of the General Health Questionnaire (GHQ-12). Victims of elder mistreatment had significantly higher levels of psychological distress than nonvictims. Social support showed a favorable effect on the level of psychological distress in victims, but not in nonvictims; victims who received more social support showed less psychological distress. A lower sense of mastery, a negative perception of self-efficacy, and a passive reaction pattern were associated with higher levels of psychological distress in victims as well as in nonvictims. The beneficial role of social support, locus of control, and perceived self-efficacy on the level of psychological distress could be of importance in the development of future intervention programs.

Ageing in the Netherlands: Structural and cultural characteristics.

This article discusses the specific situation of social policy for the elderly in the Netherlands. On the one hand, due to a prolonged high birth rate after the Second World War, the proportion of the aged is relatively moderate in comparison with surrounding countries. On the other hand, more aged people live in intramural institutions than in other countries, which contrasts with the availability of informal care, resulting from the relatively large proportion of younger persons. Some possible explanations for this paradoxical situation are explored, especially the competition between the different social "pillars" in Dutch society during the expansion of the welfare state.

Family care of impaired elderly: a role theory approach.

To understand the behaviour of family members who take care of their impaired parents, a role theoretical model is presented. The model defines three dimensions of human behaviour for assessing the behaviour of role-incumbents. These three dimensions are indicated by the questions: What should be done? What is one willing to do? What can be done? This heuristic model is applied to the caring behaviour of adult children towards their impaired parents. Within each dimension a number of variables are specified and for each of them the scattered research findings of many recent studies in this area have been summarized and integrated. It seems justified to consider the model a useful guide for future research on family care of the elderly.

Sociological research on age, aging and the aged in the Netherlands.

A review is given of the socio-gerontological research in the Netherlands. According to a frame work, organising this area of research, first an overview is presented of the studies on age and ageing and next the research on the aged is summarized. The research on age and ageing is limited. Some publications analyse the social meaning of age, some cohort studies have been conducted and recently the life course approach is getting attention. Concerning the research on the aged, the main areas studied are: living circumstances, age stratification, family and social contacts, housing, work and retirement, formal and informal care, death and dying. Since 1970 the amount of socio-gerontological research has increased. It became prominent in the eighties with the promotional activities of a special committee for gerontological research. Several universities are identified with their special areas in the sociology of ageing and the aged.