Health status and psychological well-being in elderly women: The self-system as mediator

Abstract

The purpose of this research was to explain how elderly women manage to maintain high levels of psychological well-being despite losses associated with aging, especially loss of health, and to examine this process in young-old and old-old women. Two hundred and forty three community-dwelling elderly women completed surveys regarding demographic characteristics, their health status, and psychological functioning.

The self-system was proposed as a mediator of the relationship between health status and psychological well-being, and a model was examined in which health status had a direct path to psychological well-being and an indirect path through the self-system. Three theoretical perspectives on the self-system were examined in this context: social integration (the self in relation to the social structure), social comparisons (the self in relation to others), and self-discrepancies (internally-generated self-evaluations). These relationships were examined using both mean-level analysis and a structural equation model.

The results of the mean-level analysis indicated that there were few differences between young-old and old-old women regarding health status, the self-system, or psychological well-being or distress. Old-old women seem to possess the physical and emotional characteristics of "survivors". However, there were differences in the self-system due to health status. Women in poor health reported lower levels of social integration, less favorable comparisons with others, and more self-discrepancies.

Models of psychological well-being and distress were tested for each of the self-system processes and for all three processes simultaneously. The results indicated that models of psychological well-being are different from models of psychological distress. Psychological well-being is best explained by the impact of health on the self-system which, has a strong effect on well-being. Psychological distress is best explained by both the direct and indirect effects of health. Health status has a significant impact on distress but also influences the self-system. The self-system, in turn, has a significant effect on psychological distress.