Using a Structural Equation Modeling approach to defining and measuring quality of life of elderly Chinese Americans

Many instruments, either generic or disease-specific, have been developed to evaluate quality of life; however, it is uncertain whether any of these scales are sufficient to describe quality of life in its entirety. Based on literature and in-depth interviews with 18 subjects from the study population, a proposed model that combined physical functioning, mental health, depression, loneliness, social function, and social resources was developed to describe a construct of quality of life using Structural Equation Modeling. Structured interview data were collected on six health measures: physical functioning, mental health and social functioning of SF-36, CESD-10, Loneliness Scale, and Social Resources Scale of OARS. Interviews with 100 community-dwelling Chinese South Floridians, aged ≥ 60, recruited through eight community-based organizations and chain referral, provided data to test the model resulting in an excellent fit (Chi Square/DF(6)=.811; CFI=1.000; RMSEA<.001; SRMR=.0429). The quality of life model for South Florida's elderly Chinese represented two distinctive dimensions: physical functioning (.89) and psychosocial aspects (.28). There was a reciprocal relationship between physical functioning and psychosocial aspects (.27). Within psychosocial aspects, loneliness (-.97) was the strongest indicator, followed by social resources (.72), depression (.62), social function (.47), and mental health (.45). Most study participants commented that they value mental health and social health nearly as much as they value physical health. The implication of these findings for public health professionals and service agencies is that culture-specific programs that promote physical functioning and alleviate social and emotional isolation would help improve and maintain quality of life for this population.