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CASP-19 special section: how does chronic disease status affect CASP quality of life at older ages? examining the WHO ICF disability domains as mediators of this relationship
- Authors:
- SEXTON E., et al
- Journal article citation:
- Aging and Mental Health, 19(7), 2015, pp.622-633.
- Publisher:
- Taylor and Francis
Objectives: The effect of chronic disease status on quality of life (QoL) has been well established. However, less is known about how chronic diseases affect QoL. This article examines impairment in three domains of the WHO International Classification of Functioning, Health and Disability (ICF) – body function, activity and participation, as well as affective well-being, – as potential mediators of the relationship between chronic disease and QoL. Method: A cross-sectional sample (n = 4961) of the general Irish community-dwelling population aged 50+ years was obtained from the Irish Longitudinal Study of Ageing (TILDA). The CASP measure of QoL was examined as two dimensions – control/autonomy and self-realisation/pleasure. Structural equation modelling was used to test the direct and indirect effects of chronic disease on QoL, via variables capturing body function, activity, participation and positive affect. Results: A factor analysis showed that indicators of body function and activity loaded onto a single overall physical impairment factor. This physical impairment factor fully mediated the effect of chronic disease on positive affect and QoL. The total effect of chronic disease on control/autonomy (−0.160) was primarily composed of an indirect effect via physical impairment (−0.86), and via physical impairment and positive affect (−0.45). The decomposition of effects on self-realisation/pleasure was similar, although the direct effect of physical impairment was weaker. The model fitted the data well (RMSEA = 0.02, TLI = 0.96, CFI = 0.96). Conclusion: Chronic disease affects QoL through increased deficits in physical body function and activity. This overall physical impairment affects QoL both directly and indirectly via reduced positive affect. (Publisher abstract)
Issues of empowerment: anti-oppressive groupwork by disabled people in Ireland
- Authors:
- NI CHORCORA Maire, JENNINGS Eddie, LORDAN Nuala
- Journal article citation:
- Groupwork, 7(1), 1994, pp.63-78.
- Publisher:
- Whiting and Birch
Examines the dilemmas inherent in working to empower marginalised groups. Seeks to analyse the difficulties of a groupwork model which views empowerment as a political process. The authors discuss their experience as disabled people in the development of a group, where members concern and commitment was to overcome their feelings of powerlessness. The paper concludes by identifying key issues in the groupwork process which facilitated empowerment, and enabled members to take control and challenge their oppressors.